【摘要】 目的对元代以前、明清时期及近现代骨痹相关文献进行系统整理研究,统计分析不同时期骨痹内治方药的用药规律。方法查录秦汉至近现代医学著作,建立骨痹治疗的方剂数据库,对不同时期所用方药进行统计分析,比较不同时期治疗骨痹所用方药在功效、四气、五味、归经方面用药特点的变化规律。结果元代以前应用频数最高的3类药物依次为补虚药、温里药、活血化瘀药,明清时期应用频数最高的3类药物依次为补虚药、解表药、活血化瘀药,近现代应用频数最高的3类药物依次为补虚药、活血化瘀药、祛风湿药。元代以前补虚药使用频率与明清时期比较差异有统计学意义(P <0.05),元代以前、明清时期活血化瘀药、祛风湿药使用频率与近现代比较差异有统计学意义(P <0.05),3个时期补虚药、活血化瘀药、祛风湿药使用频率组间比较差异有统计学意义(P <0.05)。元代以前应用频率最高的3类药物的药性依次为温、平、热,明清时期及近现代应用频率最高的3类药物的药性依次为温、平、寒。3个时期温性、热性、寒性药物使用频率比较差异均有统计学意义(P <0.05)。元代以前应用频率最高的3类药物的药味依次为辛、甘、苦,明清时期及近现代应用频率最高的3类药物的药味依次为甘、辛、苦。3个时期辛、苦、咸、酸味药物使用频率组间比较差异有统计学意义(P <0.05)。元代以前应用频率最高的3类药物归经依次为肝经、心经、肾经,明清时期及近现代应用频率最高的3类药物归经依次为肝经、心经、脾经。3个时期肝经、肾经、脾经、肺经、膀胱经、胃经药物使用频率组间比较差异有统计学意义(P <0.05)。结论通过分析不同时期骨痹内治方药的用药规律,可以看出历代医家治疗骨痹均多用固肾补虚、活血化瘀,辛开苦燥、甘温并补之药,平调脏腑,标本兼顾。明清时期及近现代用药开始重视脾经药物的使用,针对瘀、痰、邪的外因与本虚的内因以温肾补益为主,兼以祛痰化湿、祛风通络。更多还原

【Abstract】 Objective To study medication rule of oral drugs on bone rheumatism in different historical stages( before Yuan Dynasty,Ming and Qing dynasties and modern times) by systematic research of related literature. Method: We consulted medical works since Qin and Han Dynasties,performed statistical analysis of oral drugs on bone rheumatism in different stages by establishing a database,and compared medication rule in terms of efficacy,four qi,five wei,meridian. Results The 3 commonly in drug application were Buxu drug,Wenli drug,Huoxue Huayu drug before Yuan Dynasty,Buxu drug,Jiebiao durg,Huoxue Huayu drug on Ming and Qing Dynasties,and Buxu drug,Huoxue Huayu drug,Qufengshi drug on Modern times( P <0. 05). the application frequency of buxu drug were significant difference before the Yuan Dynasty vs Ming and Qing Dynasties( P < 0. 05),and with significantly different in application frequency of Huoxue Huayu drug and Qufengshi drug on Ming and Qing Dynasties vs modern times( P < 0. 05),the application frequency of the above three were similar during the three stages( P < 0. 05). The application frequency in drug properties were 3 commonly as warm,calm and hot before the Yuan Dynasty; and warm,calm,and cold on Ming and Qing Dynasties and modern times; difference was significant of them in the three periods( P <0. 05). The application frequency of drug taste were bitter,salty,and sour drugs,there was significant difference in the use of them in the three periods( P < 0. 05). The application frequency of drugs meridian were mainly the liver meridian,heart meridian,kidney meridian before Ming Dynasty; and liver meridian,heart meridian,spleen meridian on Ming and Qing Dynasties,liver meridian,kidney meridian,spleen meridian,lung meridian,as well as stomach meridian on modern times,and with a statistically significant difference in the three stages( P < 0. 05). Conclusion The medication rule of oral drugs on bone rheumatism in different stages indicates that the application frequency of Gushen Buxu,Huaxue Huayu,Xinkai Kuzao,Ganwen Bingbu were more by the ancient physicians,meanwhile with giving consideration to specimens. Since the Ming and Qing Dynasties,the physicians pay attention to spleen meridian drugs; in the external cause of stasis,phlegm and evil as well as the internal cause of body deficiency,Wenshi Buyi are the main,with the assist of Qufeng tongluo,Qutan Huashi.更多还原