许鑫梅教授治疗胃痛的经验总结
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摘要
目的
     胃痛是脾胃病,消化系统疾病之一,是临床的常见病和多发病。许鑫梅教授是广东省名老中医,擅长治疗消化系统疾病。本研究通过总结分析许鑫梅教授处方用药规律来研究其治疗胃痛的临床经验及学术思想,对发挥中医药治疗胃痛病的优势有着积极的推动作用。
     方法
     通过在广州中医药大学第一附属医院门诊跟诊,收集许鑫梅教授治疗胃痛病例300例,运用统计软件SPSS17.0对许教授在临床上所用药物进行频数分析、聚类分析、因子分析,并对药物性味归经进行总结,得出许鑫梅教授治疗胃痛处方用药特点,并总结其治疗此病的临床经验及学术思想。
     结果
     一、许鑫梅教授在临床上治疗胃痛方面的特点:
     1.辨证求因,把握病机,厘清类型。2.辩证辨病,中西结合。3.辨咽喉提出“胃咽合病”
     二、许鑫梅教授对胃痛治疗思路的特点
     总结了许鑫梅教授在临床上治疗胃痛的常用52味的中药里核心药物是:太子参、党参、白术、茯苓、法夏、苏梗、浙贝、郁金、砂仁、瓦楞子、木贼草及甘草。上述药物中:党参或太子参、白术、茯苓及甘草为四君子汤的组成药物,是作为治疗胃痛的主方。在治疗上以脾胃论治,注重于益气健脾。调肝和胃,注重调畅气机。合并“胃咽合病”、“治上应不忘顾下”的治疗。同时,注重湿邪为患,理气化湿为主。
     结论
     本研究所得结果总体上反映出许鑫梅教授在临床诊治胃痛的用药规律。使许鑫梅教授诊治胃痛的特色和经验得到了显凸和数据上的支持,这可丰富了名老中医辨治胃痛的临证经验和学术思想,为临床实践提供了客观的依据。
Objective
     Gastralgia is a gastrointestinal disease. It is a common and recurrent digestive system disease in the clinical. Professor Xu Xinmei is a famous Traditional Chinese Medicine's gastroenterologist in the Guangdong (Canton) province. This article is a clinical experience'and academic ideological research by summarizing and analyzing the medication regulation of the Prof. Xu, to play an active role in promoting the advantages of the TCM in the treatment of gastralgia.
     Methods
     By following Prof. Xu through her clinical practices in The First Affiliated Hospital of Guangzhou University of Chinese Medicine,300medical records of gastralgia are collected. Using the statistical data software SPSS17.0, processing Frequencies Analysis, Cluster Analysis and Factor
     Analysis on the Chinese medicines in her prescription, then summarize the efficacies on the nature, flavor and meridian tropism of the Chinese medicines.
     The medication features of Prof. Xu's prescriptions of the gastralgia are obtained and her precious clinical experiences and the academic ideologies are concluded in this research.
     Result
     1. The features of Prof.Xu in the clinical treatment of the gastralgia:
     (1) Determination of etiologic factors based on differentiation; handle the pathogenesis; differentiate the kinds;
     (2) Differentiations of syndromes and diseases, integrated Chinese and modern medicines;
     (3) Distinguish pharynx and larynx, suggested "gastric-pharyngeal related disease"
     2. The clinical experiences and academic ideologies Through the summarization,52common use Chinese medicines were found in the clinical prescriptions of Prof. Xu. And, the core Chinese medicines are Radix Pseudostellariae, Codonopsis pilosula, Rhizoma Atractylodis Macrocephalae, Poria cocos, Rhizoma Pinelliae Preparatum, Caulis Perillae, Fritillaria thunbergii Miq, Radix Curcumae, fructus amomi, Concha arcae, Equisetum hiemale Linne and Glycyrrhizae Radix. In these Chinese medicines, Radix Pseudostellariae, Codonopsis pilosula, Rhizoma Atractylodis Macrocephalae, Poria cocos and Glycyrrhizae Radix, are the composition of the "Sijunzi Tang" decoction. And, the decoction of "Sijunzi Tang" is known as the main prescription in the treatment of gastralgia. Meanwhile, these treatments are guided by the theories of "Spleen and Stomach" of TCM, in which focus on replenishing Qi (vital energy) to invigorate spleen. Prof. Xu often regulating liver and stomach with the sense of regulating Qi circulation combine with the treatment of "gastric-pharyngeal related disease". Meanwhile, lay emphasis on the dampness, and regulate the flow of vital energy "Qi" by remove and gasify the obstruction to it.
     Conelusion
     This research obtained the results that revealed the medication regulations, the features and the clinical experiences of Prof. Xu in the treatment of gastralgia, and these were raised in the data support. This research might enrich the experiences and the academic ideologies of the expert in the treatment of gastralgia, and being provided the objective basis for the clinical practice.
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