乳癖证治的古今文献研究
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摘要
乳癖是乳房内出现肿块或伴有乳房胀痛的一种病症,是临床上一种常见病,多发病,相当于西医的乳腺增生病,严重影响女性的生活质量。乳腺增生的病因尚不十分明了,目前医学界多认是由于内分泌失调而引起。部分乳腺增生长期不愈,会发生乳腺恶性病变,故对本病的研究有重大的临床意义。祖国医学对乳癖的认识具有悠久的历史,历代医家的认识不断发展从而积累了丰富的治疗经验,创立了不少行之有效的治疗方法,现代的研究则更为深入。虽然中医对该病从理论到临床都有较为丰富的论述,且使用中医中药治疗也能取得很好的疗效。但是,目前中医在该病的认识和治疗上都存在一些争议,系统的证治规律还有待进一步的研究。现代医学对该病病因认识尚不明确,治疗方法以激素调节和手术为主,激素治疗的治愈率较低,而手术治疗的复发率较高。鉴于中医中药在治疗乳癖上与现代医学相比具有相当的优势,因此,通过对乳癖文献的全面考查与研究,挖掘古代中医与现代中医认识和治疗该病的证治规律,能更有效的指导临床。
     本文以文献研究为主,全面系统搜集古代、现代关于乳癖的资料,并对相关材料进行深入的分析研究,整理和总结历代医家诊治乳癖的经验,探索证治规律,为乳癖的中医临床治疗与进一步研究,提供有益的参考。
     在对古代文献的研究中,首先探讨了本病在古代文献中对应的病名及其沿革,进而梳理出历代医家对乳癖病因病机的认识,总结了古代治疗本病的证治规律。
     对现代文献的研究,主要运用了统计学的方法,收集1999-2008年间以“乳癖”为关键词的论文,其中选取理法方药俱全的共201篇。对这些文章进行辨证分型、用药特点、药物配伍规律等统计研究,重点讨论现代中医关于本病的辩证分型和用药特点,比较古今文献对本病的辩证分型,用药方面的不同之处。以期研究结果对中医临床治疗乳癖有一定的参考价值。在分析古今文献的过程中,系统的总结和阐述乳癖的理论及整个历史时期医家遣方用药的总体规律特点,本研究既突出中医在治疗本病的优势,也为中医治疗该病提供更为系统的参考。
RUPI a disease with the symptoms of breast lumps or breast tenderness, which is often occurs in clinic. It is equivalent to mammary glands hyperplasia in Western Medicine, and seriously affects the life quality of women. The etiology of mammary gland hyperplasia is not clear yet, but the common opinions in current medical community is that it is caused by endocrine disorder. Part of patients suffer a the long-term mammary glands hyperplasia which causes breast malignancy. As a result, the research on this disease has great clinical significance. The awareness of RUPI in the Traditional Chinese Medicine(TCM) therapy has a long history. The Physicians of Past Generations did hard work in this disease and gained rich clinic experience. Many effective treatments were practiced. As time goes by, the research in present goes much further. Although a wealth of experience,from therapy to clinic practise, has been accumulated in TCM and treatments have been proved to be effective, there are still some discussions on the awareness and the treatment of the disease. Deeper research should be done to establish the system of Differentiation and Treatment of it. The pathogeny of this disease is not clear yet in Western Medicine, and medicine for hormonal regulation and surgical operation are the major treatments, but cure rate of hormone medicine is low and the recurernce rate of surgical operation is high. Since TCM has advantage in treating this disease comparing with Western Medicine, it makes sense to Consequently examine and research the documents of RUPI, and the exploration of the Differentiation and Treatment of this disease in both the ancient and modern TCM is effective direction in clinic practise.
     This paper works chiefly on the documents research. With the methods of Collecting comprehensive information, deeply analysing and research the information, collating and summarizing the experiences of the physicians of past generations, and searching for the rules of Differentiation and Treatment, many benefit references are presented.
     In the research of the ancient documents, this paper firstly discusses the corresponding name in ancient documents and the history of this disease, and then, a outline of the cognition of the pathogeny and pathogenesis has been drawn. Also this paper summarizes the rule of Differentiation and Treatment in ancient.
     In the research of the current documents, statistical method is used.201 sheets of papers include the content of principle-method-recipe-medicines with the key word of RUPI are picked from 1999 to 2008. Statistical research has been done in dialectically typing the syndromes, distinguishing the prescription characteristics, the rule of herbs combination, and so on. The contents of dialectically typing the syndromes and distinguishing the prescription characteristics in current documents are the focus of this part, which also are compared in the ancient and current documents to supply the reference to TCM clinic practice in RUPI. In the process of the analyse the documents, it summarizes and expatiates the therapy of RUPI, and the characteristics of prescription rule of physicians of past generations. The research has been done in this paper points out the advantage of TCM, and provides the reference in treating this disease in system.
引文
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