【作者】 蔡高术；

【导师】 池晓玲；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2007， 硕士

【摘要】 研究目的：本次对臌胀的研究，试图通过对中医古代文献整理与统计分析相结合的方法，探讨中医学对臌胀证治的理论认识，总结臌胀治疗的规律和方法，探索臌胀的临床诊疗新方案，为临床工作和研究工作提供新的思路。研究方法：首先，运用文献学方法，收集古代文献，对臌胀的病名、病因、病机、症状特征、鉴别诊断、治疗、预后及预防调护进行系统的分析研究；然后，通过在电子出版物《中华医典》光盘中根据检索词“臌”、“鼓”、“蛊”、“胀”在全文区中检索并筛查出臌胀的相关文献，确定历代治疗臌胀的有效方剂，将方药相关数据规范化并建立数据库，采用频数分析的分析方法对数据进行统计学分析，再结合历代对臌胀的认识，运用中医药理论对统计结果进行分析。研究结果：1．初步发现了历代臌胀的证治用药规律：宋代以前治疗臌胀方剂所用药物以泻下药、补虚药、理气药、利水渗湿药最为常用；金元时期以补虚药、理气药、利水渗湿药、泻下药最为常用；明代以理气药、补虚药、利水渗湿药、泻下药最为常用；清代以补虚药、理气药、利水渗湿药、化湿药最为常用；在本次研究所收治疗臌胀的全部方剂中，以补虚药、理气药、利水渗湿药、泻下药最为常用。2．从汉代至清代，用于治疗臌胀的各类药物总的发展趋势是：补虚药、理气药、活血化瘀药、化湿药、止血药的使用频率逐渐升高，泻下药、杀虫止痒药、涌吐药的使用频率逐步降低，利水渗湿药、温里药、开窍药的使用频率大体维持稳定，其它类别的药物使用频率的波动比较大，与各时期文献整理的结果大体一致。3．在高频药物中发现里面包含了一首方剂：香砂六君子汤，其组成药物均为高频药物。研究结论：通过以上研究，结合学习心得及导师经验，提出了臌胀防治的基本思路：(一)防治并举，防重于治，从未病先防、已病防变和病后防复三个方面探讨臌胀治未病的重要性；(二)标本兼顾，祛邪寓扶正之中，治疗本病时应标本兼顾，既要祛除气滞、血瘀、水停等致病因素以祛邪，更要注重扶助正气、补益脏腑，增强患者的抗病能力，寓祛邪于扶正之中；(三)以通为要，六辨论治。“臌则不通，通则不臌”，治臌以通为要。此外，在在常规的辨证的基础上，还应结合辨病、辨因、辨症、辨五运六气、辨体，即六辨论治；(四)习古鉴今，重视阴虚型臌胀的治疗；(五)精神安慰，生活调摄。更多还原

【Abstract】 Objective:This thesis explores the new order and method to treatment Tympanites with the means of combining literature research and statistic analysis.Methods:Firstly, the thesis analysis the development of disease’s name, pathogen, pathogenesis, symptom and characteristic, discriminate diagnosis, treatment, prognosis, prophylaxis and recuperation by the means of literature research.Secondly, make use of the Encyclipaedia of Traditional Chinese Mesicine, retrieve the literature of Tympanites, and then ascertain the available anagraph to treat Tympanites, make the data of anagraph normative to set up database, adopt frequencies to statistic analysis the datas, finally, combining the knowledge of past dynasties, analysis the statistical result make use of Traditional Chinese Mesicine theory.Results:1. Discover the therapeutic rule of Tympanites in the past dynasties: the time before Song Dynasty ,the most hackneyed medicines to cure Tympanites are Purgatives, Tonics, Drugs for Regulating the Flow of Qi、Diuretics;at the time of Jing Yuan Dynasty, the most hackneyed medicines to cure Tympanites are Tonics, Drugs for Regulating the Flow of Qi、Diuretics, Purgatives;at the time of Ming Dynasty, the most hackneyed medicines to cure Tympanites are Drugs for Regulating the Fiaw of Qi、Tonics、Diuretics、Purgatives;at the time of Qing Dynasty, the most hackneyed medicines to cure Tympanites are Tonics、Drugs for Regulating the Flow of Qi、Diuretics、Drugs for Resolving;at the whole time of past dynasties, the most hackneyed medicines to cure Tympanites are Tonics、Drugs for Regulating the Flow of Qi、Diuretics、Purgatives.2. From Han Dynasty to Qing Dynasty, the development tendency of all kinds of medicines to cure Tympanites is :the use frequency of Tonics、Drugs for Regulating the Flow of Qi、Drugs for Invigorating BLOOD Circulation and Eliminating Blood Stasis、Drugs for Resolving, Hemostatics rises gradually, the use frequency of Purgatives,Anthelmintic,Nauseant decline s gradually, the use frequency of Diuretics, Drugs For Dispelling Internal Cold、Aromatic Stimulants keeps level off, the use frequency of others undulates greatly, this correspond with the conclusion of literature research.3. Discover a anagraph in the high frequency medicines:Xiangsha Liujunzi Tang. Its components all are high frequency medicines.Conclusions:Combining the study realization and the tutor’ s experience, the article provide new clues to the prevention and treatment of Tympanites with the means of above study. Firstly, the prevention and treatment are together, and prevention is more important zhan treatment. Secondly, treat both the incidental and fundamental aspects, elimination the pathogenic factors in strengthening the body resistance. Thirdly, ecphractic is the sticking point, combining differentiation of disease, factor, symptom, five movement and six climates, constitution on the basic of routine differentiation of symptoms and signs. Fourthly, pay attention to tympanites with yin-deficiency. Fifth, mind-cure and recuperation are demanded.更多还原