【作者】 孟小斐；

【导师】 韩涛；

【作者基本信息】 山东中医药大学 ， 方剂学， 2009， 硕士

【摘要】 目的:《素问·宣明五气》曰:“五脏化液,心为汗。”本研究旨在通过分析古代治疗心系疾病方剂中调汗药(具有发汗作用或止汗作用的中药,简称发汗药或止汗药)的应用状况,探讨“治心调汗”的组方配伍规律,为临床治疗心系疾病提供方法学参考,并借此印证“汗为心液”之理论。方法:运用文献学的研究方法,以《中医方剂大辞典精选本》为研究范围,依据相关诊疗标准,筛选出治疗心系疾病的方剂,并建立方剂资料数据库,进行方剂信息挖掘分析,归纳总结调汗药在其中的配伍应用规律。结果:(1)《中医方剂大辞典精选本》共载治疗心系疾病方剂758首,其中配伍调汗药的方剂共512首,占到了总方剂数目的67.55%。(2)调汗药中发汗药使用居前3位的药物分别是生姜、防风、薄荷,止汗药居前3位的分别是酸枣仁、白术、白芍。(3)在使用调汗药治疗心系疾病实证、虚证、虚实夹杂证的方剂中,单独配伍发汗药的方剂比率分别为76.50%、6.59%、18.62%,其在实证中应用的比率明显高于其它证型(P＜0.01);单独配伍止汗药的方剂比率分别为12.00%、69.46%、33.79%,其在虚证中应用的比率明显高于其它证型(P＜0.01);发汗药止汗药共同配伍的方剂比率分别为11.50%、23.95%、47.59%,其在虚实夹杂证中应用的比率明显高于其它证型(P＜0.01)。(4)在使用了调汗药治疗心系疾病的血脉异常和神明异常的方剂中,单独配伍发汗药的方剂比率分别为59.22%、33.20%,其在血脉异常的疾病中配伍的比率明显高于神明异常的疾病(P＜0.01);单独配伍止汗药的方剂比率分别为26.21%、36.70%,其在神明异常的疾病中配伍的比率高于血脉异常的疾病,但P＞0.05。(5)在治疗胸痹、心痛的方剂中,单独配伍发汗药的方剂比率分别为60.00%、65.63%,单独配伍止汗药的比率分别为16.00%、21.88%;在治疗失眠、健忘、心悸、怔忡、惊悸的方剂中,单独配伍止汗药的方剂比率分别为63.83%、70.83%、70.59%、47.27%、71.74%,单独配伍发汗药的比率分别为8.51%、6.25%、17.65%、10.87%、20.00%。结论:(1)在古代治疗心系疾病的方剂中配伍调汗药的比率较高,提示在治疗中医心病的方剂中配伍调汗药是一种常用的配伍方法,亦从治法角度证明古代医家对“汗为心液”理论的重视。(2)实证中多配伍发汗药、虚证中多配伍止汗药、虚实夹杂证中多发汗药止汗药共同配伍是其一般的配伍规律。(3)治疗血脉异常的疾病多配伍发汗药、治疗神明异常的疾病多配伍止汗药是其一般的配伍规律。(4)在治疗胸痹、心痛的方剂中多配伍发汗药,治疗失眠、健忘、心悸、怔忡、惊悸的方剂中多配伍止汗药是其一般的配伍规律。更多还原

【Abstract】 Objective: According to Neijing, "Five internal organs start up fluid, the heart for sweat. "The study is to explore the compatibility rule of the Regulating Sweat Medicine in the treatment of Disease and Syndromes of Heart, and validate the theory of sweat pertaining to the fluid of the heart, and provide methodology Reference for clinic by analyzing the state of Regulating Sweat Medicine used in ancient prescription drugs for Disease and Syndromes of Heart.Method: To Select Edition of TCM Prescription Dictionary to the scope of research, based on relational clinics standard selecting prescription of Disease and Syndromes of Heart and Set up database, generalize Compatibility methods and rule of Regulating Sweat Medicine.Results: (1) There are 512 prescriptions containing Regulating Sweat Medicines from all 758 ones of Disease and Syndromes of Heart in Select Edition of TCM Prescription Dictionary, accounted for 67.55%. (2) The top five of the Regulating Sweat Medicine are Shengjiang; Suanzaoren; Baizhu; Fangfeng; Baishao. (3) It is highest that diaphoretic combined ratio of Regulating Sweat Medicines used in the prescriptions for Excess Disorder (76.50%), markedly higher than the ratios of ones for other types of syndrome(p<0.01);The anhidrotic combined ratio for deficiency disorder is highest(69.46%), compared with the ones for other type of syndromes (p<0.01); For the state of deficiency within excess Disorder, diaphoretic and anhidrotic together combined ratio is highest(47.59%), there is very significant statistic meaning (p<0.01) compared with the compatibility ratio in other type of syndromes.(4) The ratio of diaphoretic combined is highest(59.22%)in the prescriptions for Abnormal blood circulation diseases, distinctly more than the other type of syndromes (p<0.01); For Abnormal mental diseases, diaphoretic combined ratio is highest(36.70%). (5) In the prescription of thoracic obstruction and cardialgia, the diaphoretic combined ratio is 60%;65.63%; in the prescription of Insomnia and loss of memory and palpitation and severe palpitation and pavor diaphoretic combined ratio is highest(63.83%;70.83%;70.59%;47.27%;71.47%).Conclusion: (1) In the prescriptions for Disease and Syndromes of Heart, combining Regulating Sweat Medicine is a commonly used compatibility method in ancient. (2) The principle is that diaphoretic combining for Excess Disorder,and so do anhidrotic for Deficiency Disorder. (3) Diaphoretic is combined in Abnormal blood circulation diseases and anhidrotic is combined in Abnormal mental diseases is its general rule of compatibility. (4) Diaphoretic is combined in cardialgia and thoracic obstruction, anhidrotic is combined in insomnia; loss of memory; palpitation ; pavor severe; and palpitation is its general rule of compatibility.更多还原