壮医妇科学科构建及优势特色研究
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摘要
目的：构建壮医妇科学,实现壮医妇科理论继承和创新；探讨壮医治疗妇科疾病的优势病种,明确学科发展方向,为群众提供科学的就诊指南；探析壮医妇科的临床用药特点和规律,使壮医妇科方药更具临床实用性和理论指导性。
方法：①采用文献资料法收集壮医妇科资料,运用经验归纳法、比较与逻辑分析法对资料进行系统整理,分析归纳,梳理出形成壮医妇科学学科的要素,按照学科建构原则,初步构建壮医妇科学学科框架；②在学科构建基础上,采用问卷和访谈的形式,对相关专家进行调查,运用频数分析法对调查资料进行分析,了解壮医妇科优势病种；③广泛收集壮医妇科方药,对其进行系统整理,采用频数分析法,在壮医理论指导下探析壮医妇科的用药特点和规律。
结果：①明确壮医妇科学学科要素,初步构建了壮医妇科学理论和临床框架。②专家调查结果显示,壮医妇科优势病种主要集中在产后病及月经病,产后虚弱、产后风湿、产后缺乳、月经不调、痛经等是壮医妇科优势病种。③壮医妇科临床用药多以补虚、解毒、通调两路药为主。月经病、妊娠病和产后病的用药以补虚药最为多用,白带病和杂病以解毒药最为多用。温性药物较为多用,补虚常配动物药,喜用鲜药,“以红治红”、“以白治白”。
结论：①壮医妇科学是运用壮医学理论,研究妇女的生理病理特点和防治妇女特有疾病的一门临床学科。强调阴阳为本,人体的上中下三部之气与自然界的天地人三气同步,协调平衡,形成了壮医妇科学的天人自然观；脏腑骨肉气血正常是女性生理的基础,“三道”“两路”协同作用,产生和调节女性生理,构成了壮医妇科学的生理病理观；毒虚致病,内脏气血失调,三道二路阻滞(或损伤),咪花肠受损是壮医妇科学病因病机特点；多诊合参,突出腹诊、目诊、脉诊、甲诊等是壮医妇科诊断特色；辨病辨证相结合,扶正祛邪为总则,以上五方面构成了壮医妇科学理论体系。月经病、白带病、怀孕期病、产后病、妇科杂病、避孕绝育等六大类疾病的临床诊断和治疗构成了壮医妇科学临床体系。②壮医妇科在产后病和月经病的防治方面具有优势,产后虚弱、产后风湿、产后缺乳、月经不调、痛经等是壮医妇科的优势病种。③壮医妇科临床用药强调解毒、补虚、通调三道两路,组方强调公药、母药、主药、帮药、带药的有机结合,方剂药简功专,善用毒药和解毒药,补虚常配动物药,重视温性药的应用,喜用鲜药,“以红治红”、“以白治白”,经验独特。
Objectives:To construct the academic framework of gynecology in Zhuang ethnomedicine, achieve theoretical inheritance and innovation; To explore the preponderant disease of gynecology in Zhuang ethnomedicine, define the direction in subject development, provide a scientific guidance of treatment for the general public; To explore its clinical pharmacological features and rules, make the prescriptions more clinically applicable and provide better theoretical guidance.
Methods:①Using literature research, as well as experience induction, comparison and logical analysis to collect gynecological data of Zhuang ethnomedicine. The gathered information was arranged systematically and analyzed, and then summarized to obtain the essential elements that comprise the science of gynecology in Zhuang ethnomedicine. Using the principles of construction in subject disciplines, the academic framework of gynecology in Zhuang ethnomedicine was initially constructed.②Taking all the above as a basis, through questionnaires and interviews with the relevant expert's data were obtained and analyzed by using a frequency analysis to explore the preponderant disease associated with gynecology in Zhuang ethnomedicine.③Extensively collected gynecological prescriptions used in Zhuang ethnomedicine were arranged systematically and analyzed by using a frequency analysis to explore the clinical pharmacological features and rules found under the guidelines of Zhuang ethnomedicine.
Results:①Defined subject specifics of gynecology in Zhuang ethnomedicine, initially constructed the academic framework for gynecology in Zhuang ethnomedicine.②Survey on the experts shows that the preponderant gynecology diseases in Zhuang ethnomedicine were concentrated on puerperalism and emmeniopathy. These include postpartum management, postpartum asthenia, postpartum rheumatism, postpartum hypogalactia, irregular menses, menalgia and menstrual headache, etc.③The clinical medication emphasis of gynecology according to Zhuang ethnomedicine is placed on the three aspects of deintoxication, replenishing the deficient, dredging and regulating the "three paths" and "two ways". Emmeniopathy, pregnancy and post-natal disease using the notify drugs, leucorrhoea and miscellaneous diseases using the alexipharmic, invigorating with animal drugs, attaching importance to warming therapy, fresh herbs and combating medicines with its own indications. The Zhuang ethnomedicine has the unique experiences of composing prescriptions, such as "treat red in red", "treat white in white".
Conclusions:①Gynecology in Zhuang ethnomedicine is one of clinical specialties, researching the physiological and pathological characteristics, as well as disease prevention and treatment in females using its own theory, and the theory emphasizes Yin and Yang, and that the three levels of Qi (upper, middle and lower) of the human being need to be in synchronized coordination and balance with the three natural Qi (heaven, earth and, human) as this forms the divine nature of gynecology in Zhuang ethnomedicine. Normal organs, bone, muscle, Qi and blood make up the basic female physiology. The "three paths", "two ways" synergistically act, generate, and regulate female physiology, that constituting the concept of physiology and pathogenesis of gynecology in zhuang ethnomedicine. Toxin and asthenia are pathopoiesia, visceral and blood disordered, "three paths", "two ways" were blocked (or injured), uterus impaired are the etiological and pathogenesis characteristics of gynecology in zhuang ethnomedicine. It emphasized the characteristics of combining the diagnostic methods used in Zhuang ethnomedicine, particularly abdominal diagnosis, inspection, pulse diagnosis, nail diagnosis etc. Combination of disease differentiation and syndrome differentiation of gynecology in Zhuang ethnomedicine shows disease differentiation is the main method, often resulting in diagnosis of special disease treated using a special prescription. The five aspects above come into the theoretical system of gynecology in Zhuang ethnomedicine. Emmeniopathy, leukorrhea disorder, diseases during pregnancy, postpartum disease, miscellaneous gynecological diseases, contraception and sterilization, the clinical diagnosis and treatment of these six diseases forms the clinical system of Zhuang ethnomedicine for gynecology.②The preponderant gynecological diseases in Zhuang ethnomedicine were concentrated on puerperalism and emmeniopathy and including postpartum management, postpartum asthenia and postpartum rheumatism, postpartum hypogalactia, irregular menses, menalgia, and menstrual headache, etc.③The clinical medication emphasis of gynecology according to Zhuang ethnomedicine is placed on the three aspects of deintoxication, replenishing the deficient, dredging and regulating the "three paths, two ways". The prescription composition should emphasise the combination of male, female, principal, assistant and adjuvant herbs. The compositions are simple but their functions are special, being able to be used for poison with oxicodum, invigorating with animal drugs, attaching importance to warming therapy, fresh herbs and combating medicines with its own indications. The Zhuang ethnomedicine has the unique experiences of composing prescriptions, such as "treat red in red " and "treat white in white".
方法：①采用文献资料法收集壮医妇科资料,运用经验归纳法、比较与逻辑分析法对资料进行系统整理,分析归纳,梳理出形成壮医妇科学学科的要素,按照学科建构原则,初步构建壮医妇科学学科框架；②在学科构建基础上,采用问卷和访谈的形式,对相关专家进行调查,运用频数分析法对调查资料进行分析,了解壮医妇科优势病种；③广泛收集壮医妇科方药,对其进行系统整理,采用频数分析法,在壮医理论指导下探析壮医妇科的用药特点和规律。
结果：①明确壮医妇科学学科要素,初步构建了壮医妇科学理论和临床框架。②专家调查结果显示,壮医妇科优势病种主要集中在产后病及月经病,产后虚弱、产后风湿、产后缺乳、月经不调、痛经等是壮医妇科优势病种。③壮医妇科临床用药多以补虚、解毒、通调两路药为主。月经病、妊娠病和产后病的用药以补虚药最为多用,白带病和杂病以解毒药最为多用。温性药物较为多用,补虚常配动物药,喜用鲜药,“以红治红”、“以白治白”。
结论：①壮医妇科学是运用壮医学理论,研究妇女的生理病理特点和防治妇女特有疾病的一门临床学科。强调阴阳为本,人体的上中下三部之气与自然界的天地人三气同步,协调平衡,形成了壮医妇科学的天人自然观；脏腑骨肉气血正常是女性生理的基础,“三道”“两路”协同作用,产生和调节女性生理,构成了壮医妇科学的生理病理观；毒虚致病,内脏气血失调,三道二路阻滞(或损伤),咪花肠受损是壮医妇科学病因病机特点；多诊合参,突出腹诊、目诊、脉诊、甲诊等是壮医妇科诊断特色；辨病辨证相结合,扶正祛邪为总则,以上五方面构成了壮医妇科学理论体系。月经病、白带病、怀孕期病、产后病、妇科杂病、避孕绝育等六大类疾病的临床诊断和治疗构成了壮医妇科学临床体系。②壮医妇科在产后病和月经病的防治方面具有优势,产后虚弱、产后风湿、产后缺乳、月经不调、痛经等是壮医妇科的优势病种。③壮医妇科临床用药强调解毒、补虚、通调三道两路,组方强调公药、母药、主药、帮药、带药的有机结合,方剂药简功专,善用毒药和解毒药,补虚常配动物药,重视温性药的应用,喜用鲜药,“以红治红”、“以白治白”,经验独特。
Objectives:To construct the academic framework of gynecology in Zhuang ethnomedicine, achieve theoretical inheritance and innovation; To explore the preponderant disease of gynecology in Zhuang ethnomedicine, define the direction in subject development, provide a scientific guidance of treatment for the general public; To explore its clinical pharmacological features and rules, make the prescriptions more clinically applicable and provide better theoretical guidance.
Methods:①Using literature research, as well as experience induction, comparison and logical analysis to collect gynecological data of Zhuang ethnomedicine. The gathered information was arranged systematically and analyzed, and then summarized to obtain the essential elements that comprise the science of gynecology in Zhuang ethnomedicine. Using the principles of construction in subject disciplines, the academic framework of gynecology in Zhuang ethnomedicine was initially constructed.②Taking all the above as a basis, through questionnaires and interviews with the relevant expert's data were obtained and analyzed by using a frequency analysis to explore the preponderant disease associated with gynecology in Zhuang ethnomedicine.③Extensively collected gynecological prescriptions used in Zhuang ethnomedicine were arranged systematically and analyzed by using a frequency analysis to explore the clinical pharmacological features and rules found under the guidelines of Zhuang ethnomedicine.
Results:①Defined subject specifics of gynecology in Zhuang ethnomedicine, initially constructed the academic framework for gynecology in Zhuang ethnomedicine.②Survey on the experts shows that the preponderant gynecology diseases in Zhuang ethnomedicine were concentrated on puerperalism and emmeniopathy. These include postpartum management, postpartum asthenia, postpartum rheumatism, postpartum hypogalactia, irregular menses, menalgia and menstrual headache, etc.③The clinical medication emphasis of gynecology according to Zhuang ethnomedicine is placed on the three aspects of deintoxication, replenishing the deficient, dredging and regulating the "three paths" and "two ways". Emmeniopathy, pregnancy and post-natal disease using the notify drugs, leucorrhoea and miscellaneous diseases using the alexipharmic, invigorating with animal drugs, attaching importance to warming therapy, fresh herbs and combating medicines with its own indications. The Zhuang ethnomedicine has the unique experiences of composing prescriptions, such as "treat red in red", "treat white in white".
Conclusions:①Gynecology in Zhuang ethnomedicine is one of clinical specialties, researching the physiological and pathological characteristics, as well as disease prevention and treatment in females using its own theory, and the theory emphasizes Yin and Yang, and that the three levels of Qi (upper, middle and lower) of the human being need to be in synchronized coordination and balance with the three natural Qi (heaven, earth and, human) as this forms the divine nature of gynecology in Zhuang ethnomedicine. Normal organs, bone, muscle, Qi and blood make up the basic female physiology. The "three paths", "two ways" synergistically act, generate, and regulate female physiology, that constituting the concept of physiology and pathogenesis of gynecology in zhuang ethnomedicine. Toxin and asthenia are pathopoiesia, visceral and blood disordered, "three paths", "two ways" were blocked (or injured), uterus impaired are the etiological and pathogenesis characteristics of gynecology in zhuang ethnomedicine. It emphasized the characteristics of combining the diagnostic methods used in Zhuang ethnomedicine, particularly abdominal diagnosis, inspection, pulse diagnosis, nail diagnosis etc. Combination of disease differentiation and syndrome differentiation of gynecology in Zhuang ethnomedicine shows disease differentiation is the main method, often resulting in diagnosis of special disease treated using a special prescription. The five aspects above come into the theoretical system of gynecology in Zhuang ethnomedicine. Emmeniopathy, leukorrhea disorder, diseases during pregnancy, postpartum disease, miscellaneous gynecological diseases, contraception and sterilization, the clinical diagnosis and treatment of these six diseases forms the clinical system of Zhuang ethnomedicine for gynecology.②The preponderant gynecological diseases in Zhuang ethnomedicine were concentrated on puerperalism and emmeniopathy and including postpartum management, postpartum asthenia and postpartum rheumatism, postpartum hypogalactia, irregular menses, menalgia, and menstrual headache, etc.③The clinical medication emphasis of gynecology according to Zhuang ethnomedicine is placed on the three aspects of deintoxication, replenishing the deficient, dredging and regulating the "three paths, two ways". The prescription composition should emphasise the combination of male, female, principal, assistant and adjuvant herbs. The compositions are simple but their functions are special, being able to be used for poison with oxicodum, invigorating with animal drugs, attaching importance to warming therapy, fresh herbs and combating medicines with its own indications. The Zhuang ethnomedicine has the unique experiences of composing prescriptions, such as "treat red in red " and "treat white in white".
引文
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1.黄汉儒,等.中国壮医学.南宁：广西民族出版社,2000.
2.梁江洪,刘智生.壮医目诊诊断子宫肌瘤160例临床观察江西中医药,2000,31(5)：29
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5.黄瑾明,黄汉孺,黄鼎坚.壮医药线点灸疗法南宁：广西人民出版社,1986
6.邓秋妹.壮医药线点灸治疗痛经102例临床观察.中国民族医药杂志.1995,2(1)：16-17
7.梁翀华.药线点灸治疗痛经50例小结.甘肃中医,2002,15(1)：11
8.刘芳.壮医药线点灸治疗痛经.中国临床医生.2003,31(7)：46-47
9.卢英翔,壮医药线点灸合中药外敷治疗原发性痛经37例,广西中医学院学报,2004,7(4)：23
10.陈丽珍.壮医药线点灸治疗痛经103例.中国针灸,1991,11(6)：22
11.叶庆莲.壮医药线点灸治疗青少年痛经106例.中国中医药,1991,14(2)：49-51
12.莫乃金.壮医药线点灸治痛经58例.中国民族民间医药杂志,1994,(7)：41-42
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