基于《名医类案》数据分析补中益气汤方药运用规律
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摘要
[目的]探求《名医类案》中补中益气汤的方药运用规律,服务临床。[方法]基于《名医类案》原文,通过五人筛选,共选出269例符合纳入标准的医案。采集患者姓名、症状、方剂、药物等信息,根据相关教材和规范对原始数据进行标准化处理,在Microsoft Excel 2013软件中建立基础数据库并进行频数分析,得出补中益气汤的方药运用规律,最后根据中医基础理论对结果进行分析讨论。[结果]①单独运用补中益气汤不进行加减的情况有4种:虚人外感、久用寒凉之品而疾病不愈、饮食劳役损伤中焦、久病不愈或年老体弱而中气不足。②补中益气汤的常见合用方剂为六味地黄类、金匮肾气丸、六君子汤和加减八味丸。③在使用补中益气汤治疗后,使用最多的方剂为归脾汤。④在使用补中益气汤治疗前,使用最多的方剂为六君子汤。⑤补中益气汤加味使用最多的药物类别为补虚药、清热药、利水渗湿药和温里药。茯苓、麦冬和五味子的加味频次明显高于其他药物。⑥补中益气汤的减味药物主要为柴胡和升麻。[结论]在《名医类案》中,补中益气汤进行加减药味处理或和其他方剂一起使用的情况较多,具有一定的规律性。
[Objective] To find out the formula and medication rule of Tonifying the Middle and Augmenting Qi Decoction to better serve the clinic.[Methods] Based on the original text of the Mingyi Lei'an, through the screenings of five people, 269 cases of medical records meeting the inclusion criteria were selected. The patient's name, symptoms, prescriptions, traditional Chinese medicine and other information were collected, and the original data were standardized according to relevant industry textbooks and specifications. In the Microsoft Excel 2013 software, the basic database was established and frequency analysis was carried out to obtain the application rules of Tonifying the Middle and Augmenting Qi Decoction. Finally, the results were analyzed and discussed according to the basic theory of Chinese medicine. [Results] ①The use of Tonifying the Middle and Augmenting Qi Decoction alone is as follow: Weak person getting exogenous diseases; long-term use of cold traditional Chinese medicine, disease unhealed; diet or labor injury in middle-Jiao; long-term illness or old and weak, lack of Qi. ② The common combination of Tonifying the Middle and Augmenting Qi Decoction is category of Six-ingredient Rehmannia, Jingui Kidney-Qi Pill, Six Gentlemen Decoction and Jiajian Bawei Pill. ③ After treatment with Tonifying the Middle and Augmenting Qi Decoction, the most used prescription is Restoring Spleen Decoction. ④ Before using the Tonifying the Middle and Augmenting Qi Decoction, the most used prescription is Six Gentlemen Decoction. ⑤The Chinese medicine category often added by Tonifying the Middle and Augmenting Qi Decoction is tonic medicines, heat-clearing medicines, medicines for diuresis and diffusing dampness and interior-warming medicines. The frequency of use of Poria cocos, Ophiopogon japonicus and Schisandra is significantly higher than other traditional Chinese medicine. 6 The herbs reduced in Tonifying the Middle and Augmenting Qi Decoction are Bupleurum and Cimicifuga. [Conclusion] In clinic, Tonifying the Middle and Augmenting Qi Decoction is used for addition and subtraction of traditional Chinese medicine or with other prescriptions, and it has some regularity.
[Objective] To find out the formula and medication rule of Tonifying the Middle and Augmenting Qi Decoction to better serve the clinic.[Methods] Based on the original text of the Mingyi Lei'an, through the screenings of five people, 269 cases of medical records meeting the inclusion criteria were selected. The patient's name, symptoms, prescriptions, traditional Chinese medicine and other information were collected, and the original data were standardized according to relevant industry textbooks and specifications. In the Microsoft Excel 2013 software, the basic database was established and frequency analysis was carried out to obtain the application rules of Tonifying the Middle and Augmenting Qi Decoction. Finally, the results were analyzed and discussed according to the basic theory of Chinese medicine. [Results] ①The use of Tonifying the Middle and Augmenting Qi Decoction alone is as follow: Weak person getting exogenous diseases; long-term use of cold traditional Chinese medicine, disease unhealed; diet or labor injury in middle-Jiao; long-term illness or old and weak, lack of Qi. ② The common combination of Tonifying the Middle and Augmenting Qi Decoction is category of Six-ingredient Rehmannia, Jingui Kidney-Qi Pill, Six Gentlemen Decoction and Jiajian Bawei Pill. ③ After treatment with Tonifying the Middle and Augmenting Qi Decoction, the most used prescription is Restoring Spleen Decoction. ④ Before using the Tonifying the Middle and Augmenting Qi Decoction, the most used prescription is Six Gentlemen Decoction. ⑤The Chinese medicine category often added by Tonifying the Middle and Augmenting Qi Decoction is tonic medicines, heat-clearing medicines, medicines for diuresis and diffusing dampness and interior-warming medicines. The frequency of use of Poria cocos, Ophiopogon japonicus and Schisandra is significantly higher than other traditional Chinese medicine. 6 The herbs reduced in Tonifying the Middle and Augmenting Qi Decoction are Bupleurum and Cimicifuga. [Conclusion] In clinic, Tonifying the Middle and Augmenting Qi Decoction is used for addition and subtraction of traditional Chinese medicine or with other prescriptions, and it has some regularity.
引文
[1]李仁述,王秀华.补中益气汤小考[J].甘肃中医,1992,5(4):45.
[2]江瓘.名医类案[M].北京:人民卫生出社社,2005.
[3]谢鸣.方剂学[M].3版.北京:人民卫生出版社,2016:163-164.
[4]钟赣生.中药学[M].北京:中国中医药出版社,2012:1-10.
[5]杨靖.“气虚发热”中医病机理论研究现状[J].内蒙古中医药,2011,30(1):104-105.
[6]张介宾.景岳全书[M].北京:中国中医药出版社,1994:673.
[7]王霞,闫润红,青献春,等.补中益气汤随证加用茯苓初探[J].光明中医,2012,27(1):167-168.
[8]武世豪,杜金行.麦冬补气作用刍议[J].北京中医药,2016,35(3):264-266.
[9]张年顺.李东垣医学全书[M].北京:中国中医药出版社,2015:11.
[10]王玉娥,席颖颖,李媛,等.补中益气汤配伍规律现代研究进展[J].中国实验方剂学杂志,2017,23(7):221-226.
[2]江瓘.名医类案[M].北京:人民卫生出社社,2005.
[3]谢鸣.方剂学[M].3版.北京:人民卫生出版社,2016:163-164.
[4]钟赣生.中药学[M].北京:中国中医药出版社,2012:1-10.
[5]杨靖.“气虚发热”中医病机理论研究现状[J].内蒙古中医药,2011,30(1):104-105.
[6]张介宾.景岳全书[M].北京:中国中医药出版社,1994:673.
[7]王霞,闫润红,青献春,等.补中益气汤随证加用茯苓初探[J].光明中医,2012,27(1):167-168.
[8]武世豪,杜金行.麦冬补气作用刍议[J].北京中医药,2016,35(3):264-266.
[9]张年顺.李东垣医学全书[M].北京:中国中医药出版社,2015:11.
[10]王玉娥,席颖颖,李媛,等.补中益气汤配伍规律现代研究进展[J].中国实验方剂学杂志,2017,23(7):221-226.
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