消渴病古代文献研究及近30年用柴胡类方治疗资料的分析
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摘要
中医消渴病是指以多饮、多食、多尿、身体消瘦,或尿浊、尿中有甜味为主要临床表现的一种慢性病,是一种中医临床常见的内科疾病。从现代医学的角度看,中医消渴病症状特点及其发展预后与西医糖尿病的认识基本一致。现代社会中糖尿病无论在发达国家还是发展中国家：其发病率都呈上升趋势,己成为影响人们生存质量的重要疾病。糖尿病是终身性疾病,其并发症多,致残率、病死率以及对总体健康的危害程度,已排世界非传染性疾病的第3位,所以,世界各国对本病的研究和治疗都备加重视。
中医是世界医学的一个重要分支,其具有自身完备的理论体系和知识架构,数于年来中医作为捍卫国人健康的主要力量,为中华民族的发展做出了不可磨灭的贡献。中医消渴病最早在古籍《黄帝内经》中就有记载,《黄帝内经》中对其病名、症状、病因、病机、传变、治疗、预后等都进行了详细的阐述,为后世医家研究消渴病奠定了理论的基础。汉代以后医家对消渴病病因、病机极其临床治疗都多有认识和发展。
随着时代的发展,人们生活方式的改变,西医治疗的介入,消渴病病因、病机、病程发生了明显变化。古代医家对消渴病的认识,不足以应对现代临床各种情况。因此,对消渴病病机进行进一步审视,有助于加深对消渴病的理解和认识,对于消渴病临床有一定的积极意义。
[目的]通过对古代文献进行整理,归纳了古代医家对消渴病病名、病机、治疗等各方面的认识。结合现代消渴病临床情况,指出消渴病由于历史变迁,古今迥异,在这种情况下,要适应新时期的临床需求,重新审视消渴病机已显得非常必要。
本文从消渴病总属津液气化异常的角度出发,指出三焦在津液代谢中的重要作用,而柴胡类方则是针对这种病机的主治之方。通过对近30年用柴胡类方治疗消渴病资料的分析,探讨其功效及应用机制,论证三焦气化不利为消渴病重要病机,以期为消渴病临床提供一种思路和研究线索。
[方法]运用传统文献研究法,系统整理了消渴病相关古代文献及近30年运用柴胡类方治疗消渴病的文献资料,归纳整合相关内容,提取规范相关数据,总结古代医家对消渴病病名、病因、病机的认识和治疗；用Microsoft Excel和统计软件分析柴胡类方在现代糖尿病及其并发症临床中运用研究情况。
[结果]古代文献整理研究表明,古代医家多数认为消渴病病因以先天禀赋不足、情志不节、起居失常、外感邪毒以及服用石药等为主,其病机主要在于燥热伤津,虚不布津、厥阴失调、痰瘀互结几个方面。糖尿病是终身性疾病,其对人体危害最大之处,在于其并发症。糖尿病并发症多为全身血管性病变,涉及心脏、肾脏、眼睛、大脑等多个器官以及自主神经系统、周围神经系统等等。对此,中医古籍中也多有记载,认为消渴病发生后可以出现各种兼症,包括消渴兼心病、消渴兼肾病、消渴兼目疾、消渴兼痈、消渴兼阳痿等。古代文献中消渴病的治疗多从滋阴清热、温肾填精、化痰利湿、健脾益气、活血化瘀等角度为治
现代社会饮食不调、情志不节成了消渴病产生的重要病因,对于先天禀赋不足这一病因,其重要影响因素已由以往的营养不良改变为毒邪伤害胎元。现代临床消渴病病程发生了改变,患者“三多一少”典型症状比较少见,有时甚者出现无证可辨的情况,近年研究表明,以浊邪为主的痰热互结已成为消渴病主要病机表现。
对于这种情况,用中医古籍对消渴病的认识已无法解读,此时可以从消渴病总属津液代谢异常的角度来考虑。津液代谢是在脏腑作用下,在三焦通道中完成,三焦气化又能对脏腑功能提供支持、协调作用,故而三焦在消渴病发生中有重要的意义。三焦气化不利,应以调畅气机为治,而柴胡类方正是此适用方剂。柴胡类方在消渴病治疗中的运用,古代文献中比较少见,但在现代文献中却运用较多。
通过对近30年来运用柴胡类方治疗糖尿病及并发症的278篇文献相关数据进行分析后显示,柴胡类方作为十大经典类方之一,在糖尿病中运用的研究有理论探索、经验个案以及临床观察、动物实验等,其研究范围涉及糖尿病及其并发症共28种病症,而临床随机对照研究多集中于近10年,而且经Jadad量表评价分析,整体质量不高,这与中药运用于临床试验盲法难以实现有很大的关系。
在纳入研究的文献中,逍遥散治疗糖尿病及其并发症的研究最多,而且也是治疗病类最多的方剂；2型糖尿病是临床研究最多的病症,在收录文献病类中占有50%；在同一病症中,不同柴胡方剂的运用频次也不相同,如糖尿病性胃轻瘫治疗中柴胡疏肝散研究最多,糖尿病肾病中小柴胡汤研究最多,糖尿病合并高脂血症大柴胡汤研究最多。
[结论]研究结果表明对柴胡类方运用于糖尿病及其并发症治疗的临床研究逐年增多,以小柴胡汤和四逆散为基础的柴胡类方其共同功效为疏解气郁、调和阴阳,使气血冲和,邪气自去,适用于三焦气化不利的治疗。三焦交通人体上下内外,为元气运行之通道,能够调节水液代谢。在三焦畅通条件下,气化功能才能顺利实现,脏腑功能才能协调作用,水液、精微物质化生、输布、渗透、排泄等生理活动才能正常进行。而若三焦失和,气化功能受阻,人体水液、精微物质转换、运化失常,气、血、津、液不归正化而生痰、湿、瘀,就会出现口干多饮、多食易饥、小便增多、形体消瘦等一系列消渴症状,因此,三焦为气液运行的通道,为脏腑协调作用的中间环节,任何致病因素都会影响三焦气化,使津液代谢异常。所以,三焦气化不利为消渴重要病机。
柴胡类方加减变化中,多法共施,在疏解三焦郁滞的基础,扶正祛邪,使正气来复及邪浊祛除道路通畅,气化恢复正常,则津液代谢有序,气血冲和而阴阳平衡。在糖尿病临床应用中,应先辨病辩证,在柴胡证基础上根据主症不同来选用方剂。但柴胡类方为消渴病治疗的基础方剂,其应用是在脏腑功能紊乱,而实质未损的前提之下,气血脏腑虚极而致的寒热之证都不是柴胡类方剂的适应证。
Ⅲ
The dispersion-thirst disease (Xiao Ke Bing) is a kind of disease name in (TCM), which main clinical manifestations always is more drinking, more food, more urine, weight loss, or Urine turbid, sweet urine and so on. Traditional Chinese Medicine physicians of modern society account diabetes mellitus as dispersion-thirst disease. The incidence of diabetes mellitus is increasing both in developed and developing countries in modern society, and has affected the quality of people life. Diabetes is a lifelong disease, the kinds of complications, morbidity, mortality and health hazards let it ranked the world's No.3 on the overall level non-communicable diseases, therefore, the world pay more attention on the research and treatment of this disease.
Traditional Chinese Medicine is an important branch of medicine in the world, which has its own theoretical system and complete knowledge structure. Traditional Chinese medicine has made an indelible contribution to safeguard people's health as a major force in the development of the Chinese nation for thousands of years. The earliest records about dispersion-thirst disease are in Huangdi's Canon of Medicine which elaborate etiology, pathogenesis, mass change, treatment and prognosis of this disease, has laid a solid foundation for the later research. Physicians after the Han Dynasty have developed the etiology, pathogenesis of dispersion-thirst greatly.
Objective
This paper summarizes the name meaning of disease, pathogenesis, treatment and other aspects of diabetes from the ancient physicians by sorting the ancient TCM literature.has changed between past and present clinical circumstances due to historical reason, in this case, re-examine the pathogenesis of the dispersion-thirst disease has become very necessary in order to meet the needs of the new era clinical.
the dispersion-thirst disease generally belong to the unusual gasification of body fluid, and the San Jiao play a important role in body fluid metabolism, and Bupleurum class prescription is the most appropriate medicine for treating the unusual of the San Jiao. This paper also collect materials of treating diabetes with the Bupleurum class prescription through nearly 30 years, to explore its mechanisms of efficacy and application and demonstrate the adverse of San Jiao is one of an important pathogenesis in diabetes mellitus, therefore, this found may provide an idea and clue to diabetes clinical research and treatment.
Methods
This paper use traditional literature research methods, compiled the ancient literature about dispersion-thirst disease and the materials of treating diabetes with Bupleurum class prescription past 30 years systematically, integrating relevant content, extracting standardized data, summarizing the research of ancient physicians to the dispersion-thirst disease. Use Microsoft Excel and statistical software to analyze the Application of Bupleurum class prescription in the diabetes and its complications clinical.
Result
The study of TCM ancient literature review shows that most of the ancient physicians consider the cause of the dispersion-thirst disease main include improper diet、extreme changes of emotions、attacked by six climate pathogenic factors or toxin、eat more warm dry Dan Stone. Its pathogenesis has consumption of fluid transforming into dryness、the body fluid distribution because weakness, Jue Yin disorders, phlegm and stasis combined together. Many ancient Chinese book is also recorded that the dispersion-thirst disease can occur merger symptoms, including heart disease, kidney disease, eye disease, appendicitis disease, impotence diseases and so on. TCM ancient literature also record that the treatments have nourishing yin to reduce fire, warming and nourishing the kidney, drying dampness and resolving phlegm, invigorating qi and strengthening the spleen, eliminating stasis and promoting blood circulation.
In 278 articles about the treatment of diabetes and complications by using Bupleurum class prescription nearly 30 years, there has theoretical exploration, experience cases and clinical observations, animal experiments and so on, the scope of the study involved 28 kinds species of diabetes and its complications. In these articles, randomized controlled clinical research has focused on the past 10 years, and through Jadad scale evaluation and analysis, the overall quality is not high.
In the literature included in the study, Xiao Yao San is the most studied prescription, and which also has the most treatment scope; in the clinical study, diabetes of type 2 is the most studied illness; in the same disease, the use of Bupleurum formula is different frequency, such as Chai Hu Shu Gan San is the most studied at diabetic gastroparesis; Xiao Chai Hu Tang is the most studied at diabetic nephropathy.
Comclusion
The results show that clinical study about using Bupleurum class to treat diabetes and its complications increasing year by year. The Bupleurum class formula is based on Xiao Chai Hu Tang and Si Ni San, they also have effect of activating qi, balance of yin and yang, smooth activity of blood,San Jiao adverse treatment.
San Jiao is the traffic of human body, which Connect the outside and inside aspects from top to bottom, San Jiao also is the channel of Yuan-qi, and can regulate water metabolism. Under normal circumstances,San Jiao coordinate the internal organs function and order of fluid metabolism, chemical and biological substances, transmission distribution, infiltration, drainage and other physical activities can be carried out normally. If San Jiao road congestion, qi is blocked, the water fluid, subtle material conversion, transport will be disorder, gas, blood, fluid, fluid does not reformed, On the contrary, phlegm, dampness, blood stasis are produced, so the diabetes symptoms of dry mouth, thirst, appetite, urination increase, body weight loss may occur.
The changes of increasing or decreasing based on Bupleurum class prescription, make applied methods multiple. Bupleurum class prescription ease San Jiao stagnation, smooth San Jiao roads, let San Jiao rousing, and its gasification back to normal, the body fluid metabolism in order, blood with qi and the yin with yang reach equilibrium. Bupleurum class prescription apply at the clinical treatment should based on syndrome, Bupleurum class prescription is the basis part treatment for the dispersion-thirst disease, its application in the organs dysfunction, viscera asthenia is the Contraindications of Bupleurum class prescription.
中医是世界医学的一个重要分支,其具有自身完备的理论体系和知识架构,数于年来中医作为捍卫国人健康的主要力量,为中华民族的发展做出了不可磨灭的贡献。中医消渴病最早在古籍《黄帝内经》中就有记载,《黄帝内经》中对其病名、症状、病因、病机、传变、治疗、预后等都进行了详细的阐述,为后世医家研究消渴病奠定了理论的基础。汉代以后医家对消渴病病因、病机极其临床治疗都多有认识和发展。
随着时代的发展,人们生活方式的改变,西医治疗的介入,消渴病病因、病机、病程发生了明显变化。古代医家对消渴病的认识,不足以应对现代临床各种情况。因此,对消渴病病机进行进一步审视,有助于加深对消渴病的理解和认识,对于消渴病临床有一定的积极意义。
[目的]通过对古代文献进行整理,归纳了古代医家对消渴病病名、病机、治疗等各方面的认识。结合现代消渴病临床情况,指出消渴病由于历史变迁,古今迥异,在这种情况下,要适应新时期的临床需求,重新审视消渴病机已显得非常必要。
本文从消渴病总属津液气化异常的角度出发,指出三焦在津液代谢中的重要作用,而柴胡类方则是针对这种病机的主治之方。通过对近30年用柴胡类方治疗消渴病资料的分析,探讨其功效及应用机制,论证三焦气化不利为消渴病重要病机,以期为消渴病临床提供一种思路和研究线索。
[方法]运用传统文献研究法,系统整理了消渴病相关古代文献及近30年运用柴胡类方治疗消渴病的文献资料,归纳整合相关内容,提取规范相关数据,总结古代医家对消渴病病名、病因、病机的认识和治疗；用Microsoft Excel和统计软件分析柴胡类方在现代糖尿病及其并发症临床中运用研究情况。
[结果]古代文献整理研究表明,古代医家多数认为消渴病病因以先天禀赋不足、情志不节、起居失常、外感邪毒以及服用石药等为主,其病机主要在于燥热伤津,虚不布津、厥阴失调、痰瘀互结几个方面。糖尿病是终身性疾病,其对人体危害最大之处,在于其并发症。糖尿病并发症多为全身血管性病变,涉及心脏、肾脏、眼睛、大脑等多个器官以及自主神经系统、周围神经系统等等。对此,中医古籍中也多有记载,认为消渴病发生后可以出现各种兼症,包括消渴兼心病、消渴兼肾病、消渴兼目疾、消渴兼痈、消渴兼阳痿等。古代文献中消渴病的治疗多从滋阴清热、温肾填精、化痰利湿、健脾益气、活血化瘀等角度为治
现代社会饮食不调、情志不节成了消渴病产生的重要病因,对于先天禀赋不足这一病因,其重要影响因素已由以往的营养不良改变为毒邪伤害胎元。现代临床消渴病病程发生了改变,患者“三多一少”典型症状比较少见,有时甚者出现无证可辨的情况,近年研究表明,以浊邪为主的痰热互结已成为消渴病主要病机表现。
对于这种情况,用中医古籍对消渴病的认识已无法解读,此时可以从消渴病总属津液代谢异常的角度来考虑。津液代谢是在脏腑作用下,在三焦通道中完成,三焦气化又能对脏腑功能提供支持、协调作用,故而三焦在消渴病发生中有重要的意义。三焦气化不利,应以调畅气机为治,而柴胡类方正是此适用方剂。柴胡类方在消渴病治疗中的运用,古代文献中比较少见,但在现代文献中却运用较多。
通过对近30年来运用柴胡类方治疗糖尿病及并发症的278篇文献相关数据进行分析后显示,柴胡类方作为十大经典类方之一,在糖尿病中运用的研究有理论探索、经验个案以及临床观察、动物实验等,其研究范围涉及糖尿病及其并发症共28种病症,而临床随机对照研究多集中于近10年,而且经Jadad量表评价分析,整体质量不高,这与中药运用于临床试验盲法难以实现有很大的关系。
在纳入研究的文献中,逍遥散治疗糖尿病及其并发症的研究最多,而且也是治疗病类最多的方剂；2型糖尿病是临床研究最多的病症,在收录文献病类中占有50%；在同一病症中,不同柴胡方剂的运用频次也不相同,如糖尿病性胃轻瘫治疗中柴胡疏肝散研究最多,糖尿病肾病中小柴胡汤研究最多,糖尿病合并高脂血症大柴胡汤研究最多。
[结论]研究结果表明对柴胡类方运用于糖尿病及其并发症治疗的临床研究逐年增多,以小柴胡汤和四逆散为基础的柴胡类方其共同功效为疏解气郁、调和阴阳,使气血冲和,邪气自去,适用于三焦气化不利的治疗。三焦交通人体上下内外,为元气运行之通道,能够调节水液代谢。在三焦畅通条件下,气化功能才能顺利实现,脏腑功能才能协调作用,水液、精微物质化生、输布、渗透、排泄等生理活动才能正常进行。而若三焦失和,气化功能受阻,人体水液、精微物质转换、运化失常,气、血、津、液不归正化而生痰、湿、瘀,就会出现口干多饮、多食易饥、小便增多、形体消瘦等一系列消渴症状,因此,三焦为气液运行的通道,为脏腑协调作用的中间环节,任何致病因素都会影响三焦气化,使津液代谢异常。所以,三焦气化不利为消渴重要病机。
柴胡类方加减变化中,多法共施,在疏解三焦郁滞的基础,扶正祛邪,使正气来复及邪浊祛除道路通畅,气化恢复正常,则津液代谢有序,气血冲和而阴阳平衡。在糖尿病临床应用中,应先辨病辩证,在柴胡证基础上根据主症不同来选用方剂。但柴胡类方为消渴病治疗的基础方剂,其应用是在脏腑功能紊乱,而实质未损的前提之下,气血脏腑虚极而致的寒热之证都不是柴胡类方剂的适应证。
Ⅲ
The dispersion-thirst disease (Xiao Ke Bing) is a kind of disease name in (TCM), which main clinical manifestations always is more drinking, more food, more urine, weight loss, or Urine turbid, sweet urine and so on. Traditional Chinese Medicine physicians of modern society account diabetes mellitus as dispersion-thirst disease. The incidence of diabetes mellitus is increasing both in developed and developing countries in modern society, and has affected the quality of people life. Diabetes is a lifelong disease, the kinds of complications, morbidity, mortality and health hazards let it ranked the world's No.3 on the overall level non-communicable diseases, therefore, the world pay more attention on the research and treatment of this disease.
Traditional Chinese Medicine is an important branch of medicine in the world, which has its own theoretical system and complete knowledge structure. Traditional Chinese medicine has made an indelible contribution to safeguard people's health as a major force in the development of the Chinese nation for thousands of years. The earliest records about dispersion-thirst disease are in Huangdi's Canon of Medicine which elaborate etiology, pathogenesis, mass change, treatment and prognosis of this disease, has laid a solid foundation for the later research. Physicians after the Han Dynasty have developed the etiology, pathogenesis of dispersion-thirst greatly.
Objective
This paper summarizes the name meaning of disease, pathogenesis, treatment and other aspects of diabetes from the ancient physicians by sorting the ancient TCM literature.has changed between past and present clinical circumstances due to historical reason, in this case, re-examine the pathogenesis of the dispersion-thirst disease has become very necessary in order to meet the needs of the new era clinical.
the dispersion-thirst disease generally belong to the unusual gasification of body fluid, and the San Jiao play a important role in body fluid metabolism, and Bupleurum class prescription is the most appropriate medicine for treating the unusual of the San Jiao. This paper also collect materials of treating diabetes with the Bupleurum class prescription through nearly 30 years, to explore its mechanisms of efficacy and application and demonstrate the adverse of San Jiao is one of an important pathogenesis in diabetes mellitus, therefore, this found may provide an idea and clue to diabetes clinical research and treatment.
Methods
This paper use traditional literature research methods, compiled the ancient literature about dispersion-thirst disease and the materials of treating diabetes with Bupleurum class prescription past 30 years systematically, integrating relevant content, extracting standardized data, summarizing the research of ancient physicians to the dispersion-thirst disease. Use Microsoft Excel and statistical software to analyze the Application of Bupleurum class prescription in the diabetes and its complications clinical.
Result
The study of TCM ancient literature review shows that most of the ancient physicians consider the cause of the dispersion-thirst disease main include improper diet、extreme changes of emotions、attacked by six climate pathogenic factors or toxin、eat more warm dry Dan Stone. Its pathogenesis has consumption of fluid transforming into dryness、the body fluid distribution because weakness, Jue Yin disorders, phlegm and stasis combined together. Many ancient Chinese book is also recorded that the dispersion-thirst disease can occur merger symptoms, including heart disease, kidney disease, eye disease, appendicitis disease, impotence diseases and so on. TCM ancient literature also record that the treatments have nourishing yin to reduce fire, warming and nourishing the kidney, drying dampness and resolving phlegm, invigorating qi and strengthening the spleen, eliminating stasis and promoting blood circulation.
In 278 articles about the treatment of diabetes and complications by using Bupleurum class prescription nearly 30 years, there has theoretical exploration, experience cases and clinical observations, animal experiments and so on, the scope of the study involved 28 kinds species of diabetes and its complications. In these articles, randomized controlled clinical research has focused on the past 10 years, and through Jadad scale evaluation and analysis, the overall quality is not high.
In the literature included in the study, Xiao Yao San is the most studied prescription, and which also has the most treatment scope; in the clinical study, diabetes of type 2 is the most studied illness; in the same disease, the use of Bupleurum formula is different frequency, such as Chai Hu Shu Gan San is the most studied at diabetic gastroparesis; Xiao Chai Hu Tang is the most studied at diabetic nephropathy.
Comclusion
The results show that clinical study about using Bupleurum class to treat diabetes and its complications increasing year by year. The Bupleurum class formula is based on Xiao Chai Hu Tang and Si Ni San, they also have effect of activating qi, balance of yin and yang, smooth activity of blood,San Jiao adverse treatment.
San Jiao is the traffic of human body, which Connect the outside and inside aspects from top to bottom, San Jiao also is the channel of Yuan-qi, and can regulate water metabolism. Under normal circumstances,San Jiao coordinate the internal organs function and order of fluid metabolism, chemical and biological substances, transmission distribution, infiltration, drainage and other physical activities can be carried out normally. If San Jiao road congestion, qi is blocked, the water fluid, subtle material conversion, transport will be disorder, gas, blood, fluid, fluid does not reformed, On the contrary, phlegm, dampness, blood stasis are produced, so the diabetes symptoms of dry mouth, thirst, appetite, urination increase, body weight loss may occur.
The changes of increasing or decreasing based on Bupleurum class prescription, make applied methods multiple. Bupleurum class prescription ease San Jiao stagnation, smooth San Jiao roads, let San Jiao rousing, and its gasification back to normal, the body fluid metabolism in order, blood with qi and the yin with yang reach equilibrium. Bupleurum class prescription apply at the clinical treatment should based on syndrome, Bupleurum class prescription is the basis part treatment for the dispersion-thirst disease, its application in the organs dysfunction, viscera asthenia is the Contraindications of Bupleurum class prescription.
引文
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[2]余学庆,李建生.2型糖尿病患者中医证候分布规律研究[J].上海中医药大学学报,2004,18(3)：9-13
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[4]吴童.消渴病中医文献与证治规律方药研究[D].黑龙江中医药大学博士学位论文,2005
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[6]庄乾竹.古代消渴病学术史研究.中国中医科学院博士学位论文[D],2006
[7]王陇德主编.中国居民营养与健康状况调查报告之一2002综合报告[M].人民卫生出版社,2006,1：18-25
[8]仝小林等.北京市糖耐量异常和糖尿病危险因素及中医证候流行病学调查[J].北京中医药,29(10)：731-736
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[12]刘英锋.小柴胡汤类方证治分类研究[M],江西科学技术出版社,2006,1
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[17]宏宇科技.中华医典.长沙：湖南电子音像出版社,1998
[18]邢斌,曾林蕊,周纪芗.类方研究的思路与方法[J].上海中医药大学学报,2004,18(2)：17-18
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[21]李冀,张雪.浅析类方的衍化[J].辽宁中医杂志,2007,34(8)：1045
[22]刘丰熙,李刚,胥彩林等.《伤寒论》柴胡类方衍变探微[J].中医杂志,2007,48 (10)：949-950
[23]张保伟.《伤寒论》少阳病柴胡类方架构浅析[J].河南中医,2005,25(2)：7-9
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[26]刘英锋,刘敏.从三焦理论认识柴胡类证证治规律[J].中国医药学报,2002,17(12)：715-718
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[28]贾万国,张艳.柴胡汤的剂量及煮服法[J].中国现代药物应用,2008,2(12)：49-50
[29]郑丰杰.柴胡类方群药物不同剂量及煎法探讨[J].江苏中医药,2007,39(1)：48-50
[30]张智华.《伤寒论》柴胡类方“药对”研究[D].湖北中学院博士学位论文,2008
[31]王宪龄,张影.《伤寒论》柴胡类方中常用药对配伍作用探讨[J].河南中医,1996,16(4)：203-204
[32]高飞.运用多元分析方法对柴胡类方证的研究[J].中国医药学报,1992,7(2)：25-26
[33]胡燕,洪敏.柴胡类方治疗抑郁症研究[J].中国实验方剂学杂志.2010,16(17)：247-249
[34]朱萌宇,王春元.柴胡类方类方在胃肠病中的临床应用与现代研究[J].全国张仲景学术思想及医方应用研讨会论文集,2001：576-577
[35]陶方泽.小柴胡汤类方证治规律研究[D].南京中医药大学博士学位论文,2009
[36]黄海,黄珊.日本对小柴胡汤及其类方的研究与应用[J].中国医药学报,1994,9(5)：53-54
[37]李晶,胡晶,商洪才.临床研究文献质量评价工具介绍及其应用[J].新乡医学院学报,2010,27(4)：410-412
[38]郭新峰,温怀,老鹰荣等.临床试验质量评价工具及其应用[J].中国循证医学杂志,2004,4(7)：485
[39]后滕正子.大柴胡汤、八味地黄丸、白虎加人参汤对实验性糖尿病及高脂血症作用的对比研究.江西中医学院学报.1991,118(3)：54
[40]南一,袁玲等.调化三焦方对2型糖尿病大鼠糖脂代谢的影响.宁夏医学杂志,2010,32(11)：977-979
[41]董晓蕾等.柴胡、黄芩组方合剂对糖尿病肾病大鼠尿蛋白、脂质代谢的影响.中国临床康复,2005,10(15)：97-99
[42]段有金等.五种中药对蛋白质非酶糖基化的作用.中国糖尿病杂志,1998,6(4)：227-229
[43]夏涵,程家正.试论三焦[J],上海中医学杂志,1958,10：82
[44]陈亨平.“三焦一受体说”之我见[J],黑龙江中医药,1997,4：55
[45]封银曼.试论三焦的微循环实质[J],河南中医,1993,3：102
[46]章格.三焦实质探讨[J],中医药学报,1999,5：7
[47]平男.关于三焦心包的解剖学研究[J],中国医药学报,2002,11：699.
[48]吴逸民.试论三焦与内分泌系统的相似性[J],辽宁中医杂志,1990,10：1
[49]王智明.脂肪组织的内分泌功能与三焦实质[J],中医药学刊,2003,8：1312
[50]陈长青,熊曼琪,李赛美.消渴病(糖尿病)的病机研究进展[J].中国中医基础医学杂志,2002,8(10)：72-74
[51]王庆其,周国琪.黄帝内经专题研究[M],上海中医药大学出版社,2002：108-112
[52]赵昱,仝小林等.开郁清热法与滋阴清热法治疗2型糖尿病的临床比较研究.辽宁中医药杂志,2008,35(2)：223-225
[53]王琦.中医体质学说研究现状与展望[J].中国中医基础医杂志,2000,8(2)：6-15
[2]余学庆,李建生.2型糖尿病患者中医证候分布规律研究[J].上海中医药大学学报,2004,18(3)：9-13
[3]段军,仝小林.消渴病的初始病机及其演变浅谈[J].北京中医,2007,26(3)：157-159
[4]吴童.消渴病中医文献与证治规律方药研究[D].黑龙江中医药大学博士学位论文,2005
[5]郑红.消渴病及其并病方药证治规律研究[D].山东中医药大学,2005
[6]庄乾竹.古代消渴病学术史研究.中国中医科学院博士学位论文[D],2006
[7]王陇德主编.中国居民营养与健康状况调查报告之一2002综合报告[M].人民卫生出版社,2006,1：18-25
[8]仝小林等.北京市糖耐量异常和糖尿病危险因素及中医证候流行病学调查[J].北京中医药,29(10)：731-736
[9]夏瑢.中医三焦气化理论的应用研究——对糖尿病病变机制的再探索[J].中华中医药学刊,2008,26(3)：532-534
[10]闫镛,王麒又.浅论三焦理论与糖尿病治疗的关系.中医学报[J],2009,24(114)：19-21
[11]黄煌.中医十大类方[M].江苏科学技术出版社,1995：52-54
[12]刘英锋.小柴胡汤类方证治分类研究[M],江西科学技术出版社,2006,1
[13]孙广全,周晓燕等.四逆散证证治规律的研究——古今四逆散证医案414例统计分析[J].中医杂志,1991(3)：8-10
[14]刘渡舟,傅士垣.伤寒论诠解[M].天津：天津科学技术出版社,1983：174
[15]张保伟.刘渡舟教授对小柴胡汤的理解与应用探微[J].北京中医药大学学报.2002(25)：48-50
[16]中医研究院,广州中医学院.中医名词术语选释[M],人民卫生出版社,1973：228
[17]宏宇科技.中华医典.长沙：湖南电子音像出版社,1998
[18]邢斌,曾林蕊,周纪芗.类方研究的思路与方法[J].上海中医药大学学报,2004,18(2)：17-18
[19]黄煌.论伤寒论类方研究的学术意义[J].南京中医药大学学报,1995,11(2)：18-20
[20]周鸿艳.柴胡研究简史[D].黑龙江中医药大学硕士学位论文,2003
[21]李冀,张雪.浅析类方的衍化[J].辽宁中医杂志,2007,34(8)：1045
[22]刘丰熙,李刚,胥彩林等.《伤寒论》柴胡类方衍变探微[J].中医杂志,2007,48 (10)：949-950
[23]张保伟.《伤寒论》少阳病柴胡类方架构浅析[J].河南中医,2005,25(2)：7-9
[24]周尔文.从《伤寒论》少阳枢机看柴胡汤及类方之运用[J].天津中医学院学报：自然科学版,1986,4：20-22
[25]陈津生.《伤寒论》柴胡类方与“阳道实、阴道虚”[J].天津中医,1998,15(6)：274
[26]刘英锋,刘敏.从三焦理论认识柴胡类证证治规律[J].中国医药学报,2002,17(12)：715-718
[27]马贻超,姜建国,鲁晓明.柴胡汤类方证及和法若干问题的探讨[J].山东中医药大学学报,2003,27(1)：21-23
[28]贾万国,张艳.柴胡汤的剂量及煮服法[J].中国现代药物应用,2008,2(12)：49-50
[29]郑丰杰.柴胡类方群药物不同剂量及煎法探讨[J].江苏中医药,2007,39(1)：48-50
[30]张智华.《伤寒论》柴胡类方“药对”研究[D].湖北中学院博士学位论文,2008
[31]王宪龄,张影.《伤寒论》柴胡类方中常用药对配伍作用探讨[J].河南中医,1996,16(4)：203-204
[32]高飞.运用多元分析方法对柴胡类方证的研究[J].中国医药学报,1992,7(2)：25-26
[33]胡燕,洪敏.柴胡类方治疗抑郁症研究[J].中国实验方剂学杂志.2010,16(17)：247-249
[34]朱萌宇,王春元.柴胡类方类方在胃肠病中的临床应用与现代研究[J].全国张仲景学术思想及医方应用研讨会论文集,2001：576-577
[35]陶方泽.小柴胡汤类方证治规律研究[D].南京中医药大学博士学位论文,2009
[36]黄海,黄珊.日本对小柴胡汤及其类方的研究与应用[J].中国医药学报,1994,9(5)：53-54
[37]李晶,胡晶,商洪才.临床研究文献质量评价工具介绍及其应用[J].新乡医学院学报,2010,27(4)：410-412
[38]郭新峰,温怀,老鹰荣等.临床试验质量评价工具及其应用[J].中国循证医学杂志,2004,4(7)：485
[39]后滕正子.大柴胡汤、八味地黄丸、白虎加人参汤对实验性糖尿病及高脂血症作用的对比研究.江西中医学院学报.1991,118(3)：54
[40]南一,袁玲等.调化三焦方对2型糖尿病大鼠糖脂代谢的影响.宁夏医学杂志,2010,32(11)：977-979
[41]董晓蕾等.柴胡、黄芩组方合剂对糖尿病肾病大鼠尿蛋白、脂质代谢的影响.中国临床康复,2005,10(15)：97-99
[42]段有金等.五种中药对蛋白质非酶糖基化的作用.中国糖尿病杂志,1998,6(4)：227-229
[43]夏涵,程家正.试论三焦[J],上海中医学杂志,1958,10：82
[44]陈亨平.“三焦一受体说”之我见[J],黑龙江中医药,1997,4：55
[45]封银曼.试论三焦的微循环实质[J],河南中医,1993,3：102
[46]章格.三焦实质探讨[J],中医药学报,1999,5：7
[47]平男.关于三焦心包的解剖学研究[J],中国医药学报,2002,11：699.
[48]吴逸民.试论三焦与内分泌系统的相似性[J],辽宁中医杂志,1990,10：1
[49]王智明.脂肪组织的内分泌功能与三焦实质[J],中医药学刊,2003,8：1312
[50]陈长青,熊曼琪,李赛美.消渴病(糖尿病)的病机研究进展[J].中国中医基础医学杂志,2002,8(10)：72-74
[51]王庆其,周国琪.黄帝内经专题研究[M],上海中医药大学出版社,2002：108-112
[52]赵昱,仝小林等.开郁清热法与滋阴清热法治疗2型糖尿病的临床比较研究.辽宁中医药杂志,2008,35(2)：223-225
[53]王琦.中医体质学说研究现状与展望[J].中国中医基础医杂志,2000,8(2)：6-15