發(fā)布時(shí)間：2018-01-09 11:14

  本文關(guān)鍵詞：名老中醫(yī)許鑫梅治療胃脘痛的用藥規(guī)律研究　出處：《廣州中醫(yī)藥大學(xué)》2017年博士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 許鑫梅 胃脘痛 用藥規(guī)律 體質(zhì)

【摘要】：目的:胃脘痛是臨床上常見的中醫(yī)內(nèi)科疾病,現(xiàn)代醫(yī)學(xué)把上腹部疼痛為主癥的急慢性胃炎、消化性潰揚(yáng)、胃癌、功能性消化不良等疾病歸屬于胃痛的范疇。許鑫梅教授是全國(guó)名老中醫(yī)藥專家,尤善治療消化系統(tǒng)疾病。本研究通過(guò)總結(jié)許鑫梅教授處方用藥規(guī)律,研究其治療胃脘痛的臨床經(jīng)驗(yàn)及學(xué)術(shù)思想,對(duì)傳承及推廣許鑫梅教授臨證治療胃脘痛優(yōu)勢(shì)經(jīng)驗(yàn)。同時(shí)對(duì)初診患者進(jìn)行流行病學(xué)研究,完成中醫(yī)辯證分型及體質(zhì)分類,進(jìn)行統(tǒng)計(jì)分析,探討它們之間的相關(guān)性,結(jié)合許鑫梅教授臨床用藥特點(diǎn),從而為個(gè)體化治療及預(yù)防胃脘痛提供臨床依據(jù),以期提高胃脘痛的中醫(yī)藥治療效果。方法:本研究通過(guò)收集2016年3月至2016年10月于廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院嶺南名醫(yī)門診處方,共收集180張?jiān)S鑫梅教授治療胃脘痛患者的中藥處方,運(yùn)用統(tǒng)計(jì)軟件對(duì)許教授所用藥物進(jìn)行頻數(shù)分析、聚類分析,并對(duì)藥物的四氣五味及歸經(jīng)進(jìn)行總結(jié),總結(jié)許鑫梅教授臨證治療胃脘痛處方用藥特點(diǎn),并總結(jié)其治療此病的臨床經(jīng)驗(yàn)及學(xué)術(shù)思想。本研究同時(shí)對(duì)138例初診的胃脘痛患者進(jìn)行流行病學(xué)研究,對(duì)患者進(jìn)行中醫(yī)辯證分型及體質(zhì)分類,比較胃痛不同證型中不同體質(zhì)類型所占比率,從而研究它們之間可能存在的相關(guān)性,為胃痛的治療、預(yù)防提供可靠的臨床依據(jù)。所得數(shù)據(jù)采用SPSS 20.0統(tǒng)計(jì)軟件分析,采取X2檢驗(yàn)。結(jié)論:許鑫梅教授善以補(bǔ)氣健脾的藥物來(lái)治療胃脘痛,組方以四君子為基礎(chǔ),臨證用藥物無(wú)明顯寒熱偏頗,主張寒溫并用,陰陽(yáng)平調(diào)。使用甘味藥物居首,因其能補(bǔ)、能和、能緩,具有補(bǔ)虛、和中、調(diào)和藥性、緩急止痛之功,且甘味藥口感良好,減少患者飲藥的痛苦,增加醫(yī)從性。許教授臨證治療胃脘痛,注重從脾胃、肺、大腸、肝論治,主張"胃咽合病"、"治上應(yīng)不忘顧下"、情志調(diào)攝等,對(duì)胃脘痛有獨(dú)到的臨證思路。中醫(yī)辯證分型及體征分類在臨床應(yīng)用上,有一定相關(guān)性,結(jié)合許鑫梅教授臨床經(jīng)驗(yàn),對(duì)胃脘痛患者提供非藥物治療指導(dǎo),患者需養(yǎng)成良好起居、飲食習(xí)慣,醫(yī)生在治療過(guò)程中需適當(dāng)進(jìn)行心理干預(yù)。
[Abstract]:Objective: epigastric pain is a common internal medicine disease in traditional Chinese medicine. Modern medicine is characterized by acute and chronic gastritis with epigastric pain. Functional dyspepsia and other diseases belong to the category of stomach pain. Professor Xu Xinmei is a famous Chinese medicine expert, especially good at treating digestive system diseases. To study its clinical experience and academic thinking in the treatment of epigastric pain, to inherit and promote Professor Xu Xinmei's clinical experience in the treatment of epigastric pain, and to carry out epidemiological study on newly diagnosed patients. Complete TCM dialectical classification and constitution classification, statistical analysis, explore the correlation between them, combined with the clinical characteristics of Professor Xu Xinmei, so as to provide a clinical basis for individualized treatment and prevention of epigastric pain. Methods: from March 2016 to October 2016 in Guangzhou University of traditional Chinese Medicine Hospital Lingnan famous out-patient prescriptions were collected. A total of 180 prescriptions of Professor Xu Xinmei for the treatment of epigastric pain were collected. The frequency and cluster analysis of the drugs used by Professor Xu were analyzed by statistical software. The clinical experience and academic thoughts of Professor Xu Xinmei in treating epigastric pain were summarized. An epidemiological study was carried out on 138 newly diagnosed patients with epigastric pain. In order to study the possible correlation between the different types of stomach pain and the treatment of stomach pain, the patients were classified by TCM dialectical classification and physique classification, and the ratio of different types of stomach pain was compared. The data were analyzed by SPSS 20.0 statistical software and X2 test. Conclusion: professor Xu Xinmei is good at treating epigastric pain with the medicine of invigorating qi and invigorating spleen. The prescription is based on the four gentlemen, and the medicine used in clinical syndrome has no obvious bias of cold and heat, and advocates the use of cold and temperature, Yin and Yang leveling. The use of sweet flavor medicine is the first, because it can supplement, can and, can slow down, and has the ability of tonifying deficiency, harmony and medicine. Urgent pain relief, and the taste of sweet medicine good, reduce the pain of patients drink drugs, increase the medical compliance. Professor Xu clinical treatment of epigastric pain, focus on the spleen and stomach, lung, large intestine, liver treatment, advocate "gastropharyngeal syndromes." "We should not forget to take care of the treatment", such as emotional adjustment, etc., there is a unique clinical symptoms of epigastric pain. Dialectical classification of TCM and physical signs in clinical application, there is a certain relevance, combined with Professor Xu Xinmei's clinical experience. Patients with epigastric pain should be given non-drug treatment guidance. Patients should develop good living and eating habits. Doctors should take psychological intervention in the course of treatment.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類號(hào)】：R249;R256.33

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