张铁忠补益脾肾、升降气机治疗老年病学术思想和经验总结
|
摘要
本研究从张铁忠教授论治老年病的学术思想、临床经验进行分析和探讨,并应用数据挖掘技术对张铁忠教授治疗的老年病例进行挖掘、分析,以揭示张铁忠教授的选方用药规律,进一步探讨其在老年病治疗中学术思想、临床经验,以期充分地学习、更好地传承导师的思想、经验,并有所创新。
1目的：通过跟师学习,并应用数据挖掘技术对张铁忠教授治疗的老年病例进行挖掘、分析,以揭示张铁忠教授在老年病治疗中的选方用药规律,进一步探讨其在老年病治疗中学术思想、临床经验,在独立临床过程中加以发挥应用,并有所创新,为中医药治疗老年病提供更多、更好的方法和新的见解。
2方法：
2.1对张铁忠教授论治老年病的学术思想进行探讨、分析。
2.2对张铁忠教授在老年病诊疗中的治疗经验、新的观点进行整理、阐述和研究、分析。
2.3运用数据挖掘技术对张铁忠教授治疗老年病的处方进行数据挖掘。
2.3.1处方数据库的建立：以Epidata数据库平台为基础,建立名老中医经验总结录入模板,将623张处方录入到Epidata数据库平台,形成病历数据库。
2.3.2数据挖掘方法：单味药采用频次统计法,药对之间的关联使用改进的互信息,多味药之间复杂的关联使用复杂系统熵聚类。
3结果：
3.1张铁忠教授论治老年病学术思想：五脏虚损、重在脾肾,注重调补脾肾；升降失常,五脏乖戾,重视气机升降；祛邪首重化痰。
3.2张铁忠教授论治相关老年病的临床经验：
3.2.1老年高血压证型以肝肾阴虚阳亢及脾虚痰湿为主,临床治疗可以化繁为简,均可在肝肾阴虚阳亢及脾虚痰湿的基础上加减化裁。方药以天麻钩藤饮、半夏白术天麻汤为基本方加减化裁。
3.2.2老年糖尿病患者病机特点为脾肾不足、气阴两虚；治疗用“健脾补肾泄浊方”(炙黄芪、炒山药、苍术、炒白术、泽泻、茯苓、干荷叶、女贞子、何首乌),不仅能缓解症状,而且有较好的降血糖效果。
3.2.3以“大肠积滞”立论,从脾肾不足、升降失司立法论治老年性便秘,应用“济川煎”加焦槟榔、生白术、火麻仁为主治疗老年性便秘,效果良好。
3.2.4立“水瘀”论,从水瘀论治老年慢性下肢静脉性水肿。老年慢性下肢静脉性水肿,其木因脾肾亏虚,其标为水瘀互结,用“五神汤”加减来治疗,临床效果良好。
3.2.5应用辛开苦降、升降气机法治疗多种老年脾胃疾病,根据虚实之主次、寒热之轻重,随证选择枳实消痞丸、半夏泻心汤、小陷胸汤、左金丸,具有很好的临床疗效。并发挥应用于冠心病、失眠、便秘、心悸、抑郁证的治疗,亦有良效。
3.2.6心肾相交在机体气机升降中具有重要作用,应用交通心肾以升降气机的方法治疗多种病症,取得了良好的疗效。应用桑螵蛸散调补心肾、交通心肾治疗老年人膀胱过度活动症、压力性尿失禁,效果良好；应用天王补心丹补水以济火,补血以养心,用于心肾阴血亏虚、心肾不交所致的心悸、怔忡、抑郁、焦虑、多汗等病证,符合老年病的病机特点,疗效良好。
3.2.7提出“老年多郁”观点。老年人抑郁症患病率高,常六郁并存。以自拟“加味越鞠丸”(由香附、川芎、苍术、焦神曲、栀子、半夏曲、石菖蒲、炙远志、白蒺藜、生龙齿组成)来治疗老年郁病,疗效确切。
3.2.8从“痰瘀证”论治老年心脑血管疾病,创“通脉益智胶囊”治疗血管性痴呆、腩血管疾病,具有明确的疗效,并具有很好的抗动脉粥样硬化、稳定斑块的作用。
3.3运用数据挖掘技术探讨张铁忠教授治疗老年病经验。
3.3.1张铁忠教授在相关老年病治疗中临床最常用药有茯苓、白术、当归、川牛膝、泽泻、生地黄、石莒蒲、熟地黄、川芎、山茱萸、尘栀子、炙甘草、清半夏、远志、益母草、白芍、陈皮、天麻、首乌藤、钩藤、枳实、苍术、肉苁蓉23味.使用频次均在100以上,分别具有健脾、化痰、祛湿、补肾、理气、平肝、清肝、安神、宁神、活血利水、交通心肾作用,揭示了张铁忠教授治疗老年病重视调补脾肾、升降气机的学术思想和经验。
3.3.2通过复杂系统熵聚类分析方法得到的药物的核心组合：杜仲、钩藤、桑寄生、石决明、天麻、益母草是张铁忠教授治疗老年高血压、眩晕的最常用药物组；肉苁蓉、当归、升麻、枳实、焦槟榔、火麻仁是张铁忠教授治疗老年便秘的核心用药；香附、川芎、苍术、半夏曲、焦神曲、白蒺藜为治疗老年郁病的核心药物组；黄芪、苍术、山药组,山药、女贞子、山茱萸组,茯苓、山药、山荣萸组是治疗糖尿病的核心药物组；百部、紫菀、前胡、白前是张铁忠教授治疗咳嗽的常用药物；石菖蒲、远志、酸枣仁、生龙齿入是交通心肾的常用药物。揭示了张铁忠教授在老年病具体病证治疗中组方及用药的特点、规律。
3.3.3张铁忠教授在相关老年病治疗中的常用药对22对,其关联系数均大十0.05。主要有白术配泽泻、白术配枳实、高良姜配香附、酸枣仁配柏子仁、石菖蒲配远志、女贞子配早莲草、黄芪配山药、地龙配荆芥、川牛膝配益母草、龟板配生磁石等。有利于进一步理解张铁忠教授药物的配伍规律。
3.4发挥、创新：将导师交通心肾法发挥应用。
3.4.1桑螵蛸散调补心肾、交通心肾治疗老年抑郁症,取得了较好的效果。
3.4.2生慧汤心肾双补、水火相济,治疗老年性痴呆,对改善记忆力、定向力等认知功能及减轻睡眠障碍、抑郁、多疑等精神、行为症状均有一定的疗效,对减轻精神、行为症状较认知功能的改善起效早、疗效好。
3.4.3对老年高血压病的治疗,发现除滋水涵木、补肾平肝外,酌情配伍宁心安神、交通心肾药物,对缓解症状、降低血压有很好的提高疗效的作用。
4结论：
4.1张铁忠教授论治老年病“五脏虚损、重在脾肾,注重调补脾肾；升降欠常,五脏乖戾,重视气机升降；祛邪首重化痰”的学术思想,反应了老年病的病机特点,具有很好的指导意义。
4.2相关老年病治疗的临床经验,疗效确切,并提出了“大肠积滞”、“水瘀”、“老年多郁”的观点,值得进一步发挥应用。
4.3应用复杂系统熵聚类技术,对张铁忠教授治疗老年病的处方进行数据挖掘,结果揭示了张铁忠教授的处方用药规律,反应了张铁忠教授治疗老年病的学术思想和临床经验。应用现代计算机技术、信息技术等对名老中医临证过程中的资料进行数据挖掘、分析,探索名老中医的诊疗经验和学术思想,是现代师承工作的重要方法之一,对总结名老中医经验具有重要意义。
4.4桑螵蛸散治疗老年抑郁症、生慧汤对老年性痴呆患者认知功能和心理、行为症状的影响取得初步疗效,有待于进一步研究。
This study discusses the academic thoughts and clinical experiences of Professor Zhang Tiezhong in treating geriatric diseases, analyzes the cases of geriatric disease treated by him with the application of data mining, so as to disclose the medication characteristics of Professor Zhang Tiezhong, to inherit as well as develop his thoughts and experiences further and thoroughly.
1Objective:
With the application of data mining, Analyze the cases of geriatric disease collected from Professor Zhang Tiezhong's clinical practice, explores his medication characteristics, utilizes as well as develops his academic thoughts and clinical experiences in my independent practice. This research will provide new ideas and better methods for the treatment on geriatric disease by using traditional Chinese medicine (TCM).
2Methods:
2.1Discuss the academic thoughts of Professor Zhang Tiezhong in treating geriatric disease.
2.2Generalize and elaborate the clinical experiences and new views of Professor Zhang Tiezhong in treating geriatric disease.
2.3To analyze the prescription of Professor Zhang Tiezhong in treating geriatric disease by using the method of data mining.
2.3.1Establishment of prescription database:Based on the Epidata database platform, the entry template for recording the clinical experiences of famous veteran doctors of TCM is created. The prescription database is formed by inputting the623pieces of prescriptions into this entry platform.
2.3.2Method of data mining:Statistics of frequency is used in the study of single traditional Chinese drug. An improved mutual information algorithm is used in the study of the association of pair of drugs. Complex system entropy cluster analysis is used in the study of the complicated association of multiple kinds of traditional Chinese drugs.
3Results:
3.1The academic thoughts of Professor Zhang Tiezhong include the following points:emphasized on regulating and tonifying spleen and kidney when five zang organs are deficient; it should pay more attention on regulating qi movement when qi movement is in disorder and five zang organs are in disharmony. One thought is to resolve phlegm at first when need to dispel etiological factor.
3.2The clinical experiences of Professor Zhang Tiezhong include the following points:
3.2.1The dominating syndromes of senile hypertension are the syndrome of decline of yin and relative excess of yang in liver and kidney, as well as the syndrome of decline of spleen and excess of phlegm-dampness, the main prescriptions are Tianmagoutengyin and Banxiahoupotang, which can be adjusted according to the patient's specific condition.
3.3.2Developed that senile diabetes mainly attributes to deficiency in spleen and kidney as well as decline of qi and yin, the prescription of Jianpibushenxiezhuofang (composed of processed Membranous Milkvetch Root, processed Common Yam Rhizome, Chinese Atractylodes Rhizome, processed Largehead AtractylodesRhizome, Oriental Waterplantain Rhizome, Greenbrier Rhizome, dried Lotus Leaf, Glossy Privet Fruit, Tuber Fleeceflower Root)) is used, which can not only relieve symptoms, but also have a better hypoglycemic effect.
3.2.3Developed that senile constipation is due to stagnation of large intestine, or decline of spleen and kidney, or disorder of qi movement, the prescription of Jichuanjian plus baked Areca Seed, Largehead AtractylodesRhizome, Hemp Fruit is recommended, which has a desirable effect.
3.2.4Developed that senile chronic venous edema of lower extremity is resulted from stagnant water, as well as the decline of spleen and kidney, the prescription of Wushentang plus other drugs is applied, which has a pleasing effect.
3.2.5According to the patient's deficiency or excess, as well as cold or heat,the methods of Xinkaikujiang and regulating qi movement is used to treat various geriatric disease. The prescriptions such as Zhishixiaopiwan, Banxiaxiexintang, Xiaoxianxiongtang, Zuojinwan, have a needed effect, and can be used to treat the diseases such as coronary heart disease, insomnia, constipation, heart palpitations, and depression.
3.2.6The coordination of heart and kidney plays a key role in the qi movement, so that using the method of coordinating heart and kidney can achieve good effects in treating many disorders. For example, Sangpiaoqiaosan can be used to treat senile overactive bladder, stress urinary incontinence. Tianwangbuxindan can be used to treat palpitation, severe palpitation, depression, anxiety, sweating, which are resulted from decline of yin and blood in heart and kidney, or incoordination of heart and kidney.
3.2.7The aged are usually suffered by stagnation, and have a high risk of depression, which is usually due to six stagnation.He composes the prescription of Jiaweiyuejuwan (constituted of Nutgrass Galingale Rhizome, Szechuan Lovage Rhizome, Chinese Atractylodes Rhizome, stir-baked Massa fermentata dedici-nalis, Cape Jasmine Fruit, processed Pinel lia Tuber, Grassleaf Sweelflag Rhizome, processed Thinleaf Milkwort Root-bark, Puncturevine Caltrop Fruit, shenglongchi).
3.2.8Based on the phlegm and blood stasis are the mainly factors of cardiovascular and cerebrovascular disease, to establish the prescription of "Tongmaiyizhi capsulate" which has definitely effect of cerebra vascular disease and senile dementia. It could anti-arteriosclerosis and stabilizes atheromas.
3.3Using the method of data mining to explore the clinical experiences of Professor Zhang Tiezhong in treating geriatric disease
3.3. IThe most commonly used drugs in the treatment of geriatric disease by Professor Zhang Tiezhong are23kind, which include Greenbrier Rhizome, Largehead AtractylodesRhizome, Chinese Angelica, Medicinal Cyathula Root, Oriental Waterplantain Rhizome, unprocessed Rehmannia Root, Grassleaf Sweelflag Rhizome, processed Rehmannia Root, Szechuan Lovage Rhizome, Common Macrocarpium Fruit, unprocessed Cape Jasmine Fruit, processed Liquoric Root, Pinellia Tuber, Thinleaf Milkwort Root-bark, Motherwort Herb, White Paeony Root, Tangerine Peel, Tall Gastrodia Tuber, Bunge Auriculate, Gambir Plant, Immature Bitter Orange, Chinese Atractylodes Rhizome, Desertliving Cistanche. Each frequency is beyond100times.These drugs respectively have the effects such as invigorating spleen, resolving phlegm, dispelling dampness,tonifyinnng kidney, regulating qi, repressing liver yang, removing heat from liver, relieving uneasiness of mind, activating blood, dispelling water, coordinating heart and kidney. This medication discloses the academic thoughts and clinical experiences of Professor Zhang Tiezhong that it should pay more attention on regulating and tonifying spleen and kidney, as well as regulating qi movement in treating geriatric disease.
3.3.2The core of the drug combination created by Professor Zhang Tiezhong has been achieved with the application of complex system entropy cluster analysis. The most common drug combination in treating senile hypertension or senile dizziness is composed of Eucommia Bark, Gambir Plant, Chinese Taxillus Twig, Sea-ear Shell, Tall Gastrodia Tuber, and Motherwort Herb. The most common drug combination in treating senile constipation is composed of Desertliving Cistanche, Chinese Angelica, Largetrifoliolious Bugbane Rhizome, Immature Bitter Orange, Areca Seed, and Hemp Fruit. The most common drug combination in treating senile depression is composed of Nutgrass Galingale Rhizome, Szechuan Lovage Rhizome, Chinese Atractylodes Rhizome, processed Pinellas Tuber, Medicated Leaven, Puncturevine Caltrop Fruit. The most common drug combination in treating diabetes includes three sets, the one is composed of Membranous Milkvetch Root, Chinese Atractylodes Rhizome, Common Yam Rhizome; The second is composed of Common Yam Rhizome, Glossy Privet Fruit, Common Macrocarpium Fruit, and the third is composed of Common Yam Rhizome, Common Macrocarpium Fruit, and Greenbrier Rhizome. The most common drug combination in treating cough is composed of Tuber Stemona Root, aster, Common Hongfennel Root, Glaucescent Swallowwort Rhizome. The most common drug combination to coordinating heart and kidney is composed of Grassleaf Sweelflag Rhizome, Thinleaf Milkwort Root-bark, Spina Date Seed, shenglongchi. All the drug combinations reveal his characteristics and rules of medication in treating geriatric disease.
3.3.3There are22sets of often used pair of drugs in the medication of Professor Zhang Tiezhong in treating geriatric disease, the correlation coefficients of which are all greater than0.05. The main pairs of drugs include the following:Largehead Atractylodes Rhizome with Oriental Waterplantain Rhizome, Largehead Atractylodes Rhizome with Immature Bitter Orange, Lesser Galangal Rhizome with Nutgrass Galingale Rhizome, Spina Date Seed with Platycladi Seed, Grassleaf Sweelflag Rhizome with Thinleaf Mi lkwort Root-bark, Glossy Privet Fruit with Giant St. John'swort Herb, Membranous Milkvetch Root with Common Yam Rhizome, Earthworm with Fineleaf Schizonepeta Herb, Medicinal Cyathula Root with Motherwort Herb, tortoiseshell with Magnetite. The study on these pairs of drugs will help us understand the rules of medication used by Professor Zhang Tiezhong in treating geriatric disease.
3.4Develop and blaze new trail:Inherit and develop the medication of coordinating heart and kidney often used by Professor Zhang Tiezhong. I found some new use on clinic practice.
3.4.1Sangpiaoqiaosan has a better clinical efficacy in the treatment of senile depression by regulating, tonifying, coordinating heart and kidney.
3.4.2Shenghuitang has a certain efficacy in the treatment of senile dementia by tonifying, coordinating heart and kidney. This prescription can not only improve cognitive functions such as memory, orientation, but also alleviate mental and behavioral symptoms, such as sleep disorder, depression, paranoia.
3.4.3For senile Hypertension, except the method of providing water for the growth of wood, invigorating the kidney and calming the liver, use the drugs of coordinating heart and kidney, calming the heart, which could helpful reduce the blood press and relief the symptoms.
4Conclusions:
4.1The academic thoughts of Professor Zhang Tiezhong in treating geriatric disease reflect the pathological characteristics of this kind of diseases and provide good guide in clinical practice, which include the following points:it should pay more attention on regulating and tonifying spleen and kidney when five zang organs are deficient; it should pay more attention on regulating qi movement when qi movement is in disorder and five zang organs are in disharmony; Resolve phlegm at first when need to dispel etiological factor.
4.2Based on plenty of clinical experiences, Professor Zhang Tiezhong proposes many viewpoints on the treatment of geriatric disease, such as stagnation of large intestine, stagnant water, stagnation contributing to the diseases of the aged, all of which should be widespread used and further developed.
4.3With the application of complex system entropy cluster, the prescriptions of Professor Zhang Tiezhong in treating geriatric disease are analyzed, and the results disclose his rules of medication, reflect his academic thoughts and clinical experiences in treating geriatric disease. Based on modern computer technology and information technology, the data mining is one of the important methods which are mainly used not only to analyze the clinical data of famous veteran doctors of TCM, but also to explore the academic thoughts and clinical experiences of famous veteran doctors of TCM.
4.4The clinical practice proves that Sangpiaoqiaosan has a better clinical efficacy in the treatment of senile depression, and that Shenghuitang has a certain efficacy in the treatment of senile dementia, but the mechanism of both prescriptions need a further study.
1目的：通过跟师学习,并应用数据挖掘技术对张铁忠教授治疗的老年病例进行挖掘、分析,以揭示张铁忠教授在老年病治疗中的选方用药规律,进一步探讨其在老年病治疗中学术思想、临床经验,在独立临床过程中加以发挥应用,并有所创新,为中医药治疗老年病提供更多、更好的方法和新的见解。
2方法：
2.1对张铁忠教授论治老年病的学术思想进行探讨、分析。
2.2对张铁忠教授在老年病诊疗中的治疗经验、新的观点进行整理、阐述和研究、分析。
2.3运用数据挖掘技术对张铁忠教授治疗老年病的处方进行数据挖掘。
2.3.1处方数据库的建立：以Epidata数据库平台为基础,建立名老中医经验总结录入模板,将623张处方录入到Epidata数据库平台,形成病历数据库。
2.3.2数据挖掘方法：单味药采用频次统计法,药对之间的关联使用改进的互信息,多味药之间复杂的关联使用复杂系统熵聚类。
3结果：
3.1张铁忠教授论治老年病学术思想：五脏虚损、重在脾肾,注重调补脾肾；升降失常,五脏乖戾,重视气机升降；祛邪首重化痰。
3.2张铁忠教授论治相关老年病的临床经验：
3.2.1老年高血压证型以肝肾阴虚阳亢及脾虚痰湿为主,临床治疗可以化繁为简,均可在肝肾阴虚阳亢及脾虚痰湿的基础上加减化裁。方药以天麻钩藤饮、半夏白术天麻汤为基本方加减化裁。
3.2.2老年糖尿病患者病机特点为脾肾不足、气阴两虚；治疗用“健脾补肾泄浊方”(炙黄芪、炒山药、苍术、炒白术、泽泻、茯苓、干荷叶、女贞子、何首乌),不仅能缓解症状,而且有较好的降血糖效果。
3.2.3以“大肠积滞”立论,从脾肾不足、升降失司立法论治老年性便秘,应用“济川煎”加焦槟榔、生白术、火麻仁为主治疗老年性便秘,效果良好。
3.2.4立“水瘀”论,从水瘀论治老年慢性下肢静脉性水肿。老年慢性下肢静脉性水肿,其木因脾肾亏虚,其标为水瘀互结,用“五神汤”加减来治疗,临床效果良好。
3.2.5应用辛开苦降、升降气机法治疗多种老年脾胃疾病,根据虚实之主次、寒热之轻重,随证选择枳实消痞丸、半夏泻心汤、小陷胸汤、左金丸,具有很好的临床疗效。并发挥应用于冠心病、失眠、便秘、心悸、抑郁证的治疗,亦有良效。
3.2.6心肾相交在机体气机升降中具有重要作用,应用交通心肾以升降气机的方法治疗多种病症,取得了良好的疗效。应用桑螵蛸散调补心肾、交通心肾治疗老年人膀胱过度活动症、压力性尿失禁,效果良好；应用天王补心丹补水以济火,补血以养心,用于心肾阴血亏虚、心肾不交所致的心悸、怔忡、抑郁、焦虑、多汗等病证,符合老年病的病机特点,疗效良好。
3.2.7提出“老年多郁”观点。老年人抑郁症患病率高,常六郁并存。以自拟“加味越鞠丸”(由香附、川芎、苍术、焦神曲、栀子、半夏曲、石菖蒲、炙远志、白蒺藜、生龙齿组成)来治疗老年郁病,疗效确切。
3.2.8从“痰瘀证”论治老年心脑血管疾病,创“通脉益智胶囊”治疗血管性痴呆、腩血管疾病,具有明确的疗效,并具有很好的抗动脉粥样硬化、稳定斑块的作用。
3.3运用数据挖掘技术探讨张铁忠教授治疗老年病经验。
3.3.1张铁忠教授在相关老年病治疗中临床最常用药有茯苓、白术、当归、川牛膝、泽泻、生地黄、石莒蒲、熟地黄、川芎、山茱萸、尘栀子、炙甘草、清半夏、远志、益母草、白芍、陈皮、天麻、首乌藤、钩藤、枳实、苍术、肉苁蓉23味.使用频次均在100以上,分别具有健脾、化痰、祛湿、补肾、理气、平肝、清肝、安神、宁神、活血利水、交通心肾作用,揭示了张铁忠教授治疗老年病重视调补脾肾、升降气机的学术思想和经验。
3.3.2通过复杂系统熵聚类分析方法得到的药物的核心组合：杜仲、钩藤、桑寄生、石决明、天麻、益母草是张铁忠教授治疗老年高血压、眩晕的最常用药物组；肉苁蓉、当归、升麻、枳实、焦槟榔、火麻仁是张铁忠教授治疗老年便秘的核心用药；香附、川芎、苍术、半夏曲、焦神曲、白蒺藜为治疗老年郁病的核心药物组；黄芪、苍术、山药组,山药、女贞子、山茱萸组,茯苓、山药、山荣萸组是治疗糖尿病的核心药物组；百部、紫菀、前胡、白前是张铁忠教授治疗咳嗽的常用药物；石菖蒲、远志、酸枣仁、生龙齿入是交通心肾的常用药物。揭示了张铁忠教授在老年病具体病证治疗中组方及用药的特点、规律。
3.3.3张铁忠教授在相关老年病治疗中的常用药对22对,其关联系数均大十0.05。主要有白术配泽泻、白术配枳实、高良姜配香附、酸枣仁配柏子仁、石菖蒲配远志、女贞子配早莲草、黄芪配山药、地龙配荆芥、川牛膝配益母草、龟板配生磁石等。有利于进一步理解张铁忠教授药物的配伍规律。
3.4发挥、创新：将导师交通心肾法发挥应用。
3.4.1桑螵蛸散调补心肾、交通心肾治疗老年抑郁症,取得了较好的效果。
3.4.2生慧汤心肾双补、水火相济,治疗老年性痴呆,对改善记忆力、定向力等认知功能及减轻睡眠障碍、抑郁、多疑等精神、行为症状均有一定的疗效,对减轻精神、行为症状较认知功能的改善起效早、疗效好。
3.4.3对老年高血压病的治疗,发现除滋水涵木、补肾平肝外,酌情配伍宁心安神、交通心肾药物,对缓解症状、降低血压有很好的提高疗效的作用。
4结论：
4.1张铁忠教授论治老年病“五脏虚损、重在脾肾,注重调补脾肾；升降欠常,五脏乖戾,重视气机升降；祛邪首重化痰”的学术思想,反应了老年病的病机特点,具有很好的指导意义。
4.2相关老年病治疗的临床经验,疗效确切,并提出了“大肠积滞”、“水瘀”、“老年多郁”的观点,值得进一步发挥应用。
4.3应用复杂系统熵聚类技术,对张铁忠教授治疗老年病的处方进行数据挖掘,结果揭示了张铁忠教授的处方用药规律,反应了张铁忠教授治疗老年病的学术思想和临床经验。应用现代计算机技术、信息技术等对名老中医临证过程中的资料进行数据挖掘、分析,探索名老中医的诊疗经验和学术思想,是现代师承工作的重要方法之一,对总结名老中医经验具有重要意义。
4.4桑螵蛸散治疗老年抑郁症、生慧汤对老年性痴呆患者认知功能和心理、行为症状的影响取得初步疗效,有待于进一步研究。
This study discusses the academic thoughts and clinical experiences of Professor Zhang Tiezhong in treating geriatric diseases, analyzes the cases of geriatric disease treated by him with the application of data mining, so as to disclose the medication characteristics of Professor Zhang Tiezhong, to inherit as well as develop his thoughts and experiences further and thoroughly.
1Objective:
With the application of data mining, Analyze the cases of geriatric disease collected from Professor Zhang Tiezhong's clinical practice, explores his medication characteristics, utilizes as well as develops his academic thoughts and clinical experiences in my independent practice. This research will provide new ideas and better methods for the treatment on geriatric disease by using traditional Chinese medicine (TCM).
2Methods:
2.1Discuss the academic thoughts of Professor Zhang Tiezhong in treating geriatric disease.
2.2Generalize and elaborate the clinical experiences and new views of Professor Zhang Tiezhong in treating geriatric disease.
2.3To analyze the prescription of Professor Zhang Tiezhong in treating geriatric disease by using the method of data mining.
2.3.1Establishment of prescription database:Based on the Epidata database platform, the entry template for recording the clinical experiences of famous veteran doctors of TCM is created. The prescription database is formed by inputting the623pieces of prescriptions into this entry platform.
2.3.2Method of data mining:Statistics of frequency is used in the study of single traditional Chinese drug. An improved mutual information algorithm is used in the study of the association of pair of drugs. Complex system entropy cluster analysis is used in the study of the complicated association of multiple kinds of traditional Chinese drugs.
3Results:
3.1The academic thoughts of Professor Zhang Tiezhong include the following points:emphasized on regulating and tonifying spleen and kidney when five zang organs are deficient; it should pay more attention on regulating qi movement when qi movement is in disorder and five zang organs are in disharmony. One thought is to resolve phlegm at first when need to dispel etiological factor.
3.2The clinical experiences of Professor Zhang Tiezhong include the following points:
3.2.1The dominating syndromes of senile hypertension are the syndrome of decline of yin and relative excess of yang in liver and kidney, as well as the syndrome of decline of spleen and excess of phlegm-dampness, the main prescriptions are Tianmagoutengyin and Banxiahoupotang, which can be adjusted according to the patient's specific condition.
3.3.2Developed that senile diabetes mainly attributes to deficiency in spleen and kidney as well as decline of qi and yin, the prescription of Jianpibushenxiezhuofang (composed of processed Membranous Milkvetch Root, processed Common Yam Rhizome, Chinese Atractylodes Rhizome, processed Largehead AtractylodesRhizome, Oriental Waterplantain Rhizome, Greenbrier Rhizome, dried Lotus Leaf, Glossy Privet Fruit, Tuber Fleeceflower Root)) is used, which can not only relieve symptoms, but also have a better hypoglycemic effect.
3.2.3Developed that senile constipation is due to stagnation of large intestine, or decline of spleen and kidney, or disorder of qi movement, the prescription of Jichuanjian plus baked Areca Seed, Largehead AtractylodesRhizome, Hemp Fruit is recommended, which has a desirable effect.
3.2.4Developed that senile chronic venous edema of lower extremity is resulted from stagnant water, as well as the decline of spleen and kidney, the prescription of Wushentang plus other drugs is applied, which has a pleasing effect.
3.2.5According to the patient's deficiency or excess, as well as cold or heat,the methods of Xinkaikujiang and regulating qi movement is used to treat various geriatric disease. The prescriptions such as Zhishixiaopiwan, Banxiaxiexintang, Xiaoxianxiongtang, Zuojinwan, have a needed effect, and can be used to treat the diseases such as coronary heart disease, insomnia, constipation, heart palpitations, and depression.
3.2.6The coordination of heart and kidney plays a key role in the qi movement, so that using the method of coordinating heart and kidney can achieve good effects in treating many disorders. For example, Sangpiaoqiaosan can be used to treat senile overactive bladder, stress urinary incontinence. Tianwangbuxindan can be used to treat palpitation, severe palpitation, depression, anxiety, sweating, which are resulted from decline of yin and blood in heart and kidney, or incoordination of heart and kidney.
3.2.7The aged are usually suffered by stagnation, and have a high risk of depression, which is usually due to six stagnation.He composes the prescription of Jiaweiyuejuwan (constituted of Nutgrass Galingale Rhizome, Szechuan Lovage Rhizome, Chinese Atractylodes Rhizome, stir-baked Massa fermentata dedici-nalis, Cape Jasmine Fruit, processed Pinel lia Tuber, Grassleaf Sweelflag Rhizome, processed Thinleaf Milkwort Root-bark, Puncturevine Caltrop Fruit, shenglongchi).
3.2.8Based on the phlegm and blood stasis are the mainly factors of cardiovascular and cerebrovascular disease, to establish the prescription of "Tongmaiyizhi capsulate" which has definitely effect of cerebra vascular disease and senile dementia. It could anti-arteriosclerosis and stabilizes atheromas.
3.3Using the method of data mining to explore the clinical experiences of Professor Zhang Tiezhong in treating geriatric disease
3.3. IThe most commonly used drugs in the treatment of geriatric disease by Professor Zhang Tiezhong are23kind, which include Greenbrier Rhizome, Largehead AtractylodesRhizome, Chinese Angelica, Medicinal Cyathula Root, Oriental Waterplantain Rhizome, unprocessed Rehmannia Root, Grassleaf Sweelflag Rhizome, processed Rehmannia Root, Szechuan Lovage Rhizome, Common Macrocarpium Fruit, unprocessed Cape Jasmine Fruit, processed Liquoric Root, Pinellia Tuber, Thinleaf Milkwort Root-bark, Motherwort Herb, White Paeony Root, Tangerine Peel, Tall Gastrodia Tuber, Bunge Auriculate, Gambir Plant, Immature Bitter Orange, Chinese Atractylodes Rhizome, Desertliving Cistanche. Each frequency is beyond100times.These drugs respectively have the effects such as invigorating spleen, resolving phlegm, dispelling dampness,tonifyinnng kidney, regulating qi, repressing liver yang, removing heat from liver, relieving uneasiness of mind, activating blood, dispelling water, coordinating heart and kidney. This medication discloses the academic thoughts and clinical experiences of Professor Zhang Tiezhong that it should pay more attention on regulating and tonifying spleen and kidney, as well as regulating qi movement in treating geriatric disease.
3.3.2The core of the drug combination created by Professor Zhang Tiezhong has been achieved with the application of complex system entropy cluster analysis. The most common drug combination in treating senile hypertension or senile dizziness is composed of Eucommia Bark, Gambir Plant, Chinese Taxillus Twig, Sea-ear Shell, Tall Gastrodia Tuber, and Motherwort Herb. The most common drug combination in treating senile constipation is composed of Desertliving Cistanche, Chinese Angelica, Largetrifoliolious Bugbane Rhizome, Immature Bitter Orange, Areca Seed, and Hemp Fruit. The most common drug combination in treating senile depression is composed of Nutgrass Galingale Rhizome, Szechuan Lovage Rhizome, Chinese Atractylodes Rhizome, processed Pinellas Tuber, Medicated Leaven, Puncturevine Caltrop Fruit. The most common drug combination in treating diabetes includes three sets, the one is composed of Membranous Milkvetch Root, Chinese Atractylodes Rhizome, Common Yam Rhizome; The second is composed of Common Yam Rhizome, Glossy Privet Fruit, Common Macrocarpium Fruit, and the third is composed of Common Yam Rhizome, Common Macrocarpium Fruit, and Greenbrier Rhizome. The most common drug combination in treating cough is composed of Tuber Stemona Root, aster, Common Hongfennel Root, Glaucescent Swallowwort Rhizome. The most common drug combination to coordinating heart and kidney is composed of Grassleaf Sweelflag Rhizome, Thinleaf Milkwort Root-bark, Spina Date Seed, shenglongchi. All the drug combinations reveal his characteristics and rules of medication in treating geriatric disease.
3.3.3There are22sets of often used pair of drugs in the medication of Professor Zhang Tiezhong in treating geriatric disease, the correlation coefficients of which are all greater than0.05. The main pairs of drugs include the following:Largehead Atractylodes Rhizome with Oriental Waterplantain Rhizome, Largehead Atractylodes Rhizome with Immature Bitter Orange, Lesser Galangal Rhizome with Nutgrass Galingale Rhizome, Spina Date Seed with Platycladi Seed, Grassleaf Sweelflag Rhizome with Thinleaf Mi lkwort Root-bark, Glossy Privet Fruit with Giant St. John'swort Herb, Membranous Milkvetch Root with Common Yam Rhizome, Earthworm with Fineleaf Schizonepeta Herb, Medicinal Cyathula Root with Motherwort Herb, tortoiseshell with Magnetite. The study on these pairs of drugs will help us understand the rules of medication used by Professor Zhang Tiezhong in treating geriatric disease.
3.4Develop and blaze new trail:Inherit and develop the medication of coordinating heart and kidney often used by Professor Zhang Tiezhong. I found some new use on clinic practice.
3.4.1Sangpiaoqiaosan has a better clinical efficacy in the treatment of senile depression by regulating, tonifying, coordinating heart and kidney.
3.4.2Shenghuitang has a certain efficacy in the treatment of senile dementia by tonifying, coordinating heart and kidney. This prescription can not only improve cognitive functions such as memory, orientation, but also alleviate mental and behavioral symptoms, such as sleep disorder, depression, paranoia.
3.4.3For senile Hypertension, except the method of providing water for the growth of wood, invigorating the kidney and calming the liver, use the drugs of coordinating heart and kidney, calming the heart, which could helpful reduce the blood press and relief the symptoms.
4Conclusions:
4.1The academic thoughts of Professor Zhang Tiezhong in treating geriatric disease reflect the pathological characteristics of this kind of diseases and provide good guide in clinical practice, which include the following points:it should pay more attention on regulating and tonifying spleen and kidney when five zang organs are deficient; it should pay more attention on regulating qi movement when qi movement is in disorder and five zang organs are in disharmony; Resolve phlegm at first when need to dispel etiological factor.
4.2Based on plenty of clinical experiences, Professor Zhang Tiezhong proposes many viewpoints on the treatment of geriatric disease, such as stagnation of large intestine, stagnant water, stagnation contributing to the diseases of the aged, all of which should be widespread used and further developed.
4.3With the application of complex system entropy cluster, the prescriptions of Professor Zhang Tiezhong in treating geriatric disease are analyzed, and the results disclose his rules of medication, reflect his academic thoughts and clinical experiences in treating geriatric disease. Based on modern computer technology and information technology, the data mining is one of the important methods which are mainly used not only to analyze the clinical data of famous veteran doctors of TCM, but also to explore the academic thoughts and clinical experiences of famous veteran doctors of TCM.
4.4The clinical practice proves that Sangpiaoqiaosan has a better clinical efficacy in the treatment of senile depression, and that Shenghuitang has a certain efficacy in the treatment of senile dementia, but the mechanism of both prescriptions need a further study.
引文
1.王玉川.《中医养生学》.上海：上海科学技术出版社,2008.P6-23.
2.袁立人.《中医老年学》.上海：上海中医学院出版社,1992.P10-16.
3.张瞥.《实用中医老年病学》.人民军医出版社,2000.P2-7.
4.田代华整理.《黄帝内经·素问》.人民卫生出版社,2005.P1-3.
5.田代华整理.《灵枢经》.人民卫生出版社,2005.P125-137.
6.田金洲.《中医老年病学》.天津科学技术出版社,1994.P12-15.
7.梁光宇,吴绪祥.赵树森主任医师抗衰老学术思想简介.中华中医药学刊,2007：25(8)：1556-1557.
8.冀敦福,季海刚.衰老与老年病中医机制的探讨.天津中医学院学报,2004：23(4)：169-172.
9.韩振翔.脾肾在老年病防治中的作用探析.辽宁中医杂志,2004：31(9)：746-747.
10.魏敏.浅谈祖国医学对老年病的防治.中国实用医药,2009：4(29)：193-194.
11.王洪蓓,傅延龄.略论气机升降学说.中国老年保健医学,2006：4(1)：45-47.
12.应道祺.论升降出入无器不有.中医药通报,2007：6(1)：44-47.
13.蒋峰.浅谈《内经》中的升降理论.四川中医,2006：24(11)：33-34.
14.邓华亮,王玉娟.试论气机升降.辽宁中医药大掌学报,2008：10(7)：36-37.
15.张仲景.《金匮要略》.人民卫生出版社,2005.P4-5.
16.刘汴生,张思雄.《实用临床老年病学》.中国医药科技出版社,2001.P10-12.
17.王莉.葛洪养生思想探析.江西中医药,1996,28(6)：24-26.
18.陶弘景.《养性延命录》.内蒙古科学技术出版社,2002.P2-7.
19.张贤媛.中医老年病学.上海科学技术出版社,1992.P4-9.
20.巢元方.《诸病源候论》.人民军医出版社,2006.P27-28.
21.孙思邈.《千金翼方》.山西科学技术出版社,2010.P140-149.
22.马术明.孙思邈的养生观及其对现代中老年疾病防治的指导意义.河北中医,2010,29(11)：1120-1121.
23.李志更,冯岩.陈直《养老奉亲书》的学术思想与特色.吉林中医药,2011，31(6)：596-598.
24.陈直.《养老奉亲书》.人民卫生出版社,2007.P3-11.
25.李杲.《兰室秘藏》.中国中医药出版社,2007.P1-3.
26.李杲.《脾胃论》.中国中医药出版社,2007.P1-5.
27.雷晋,十波,邢湘君.老年病从脾论治.中华中医药杂志,2007,22(11)：751-754.
28.朱震亨.《丹溪心法》.人民卫生出版社,2005.P4-5.
29.朱震亨.《格致余论》.人民卫生出版社,2005.P2-3.
30.李航,杨少山.杨少山临床诊治经验拾.广州中医药大学学报,2007,24(5)：430-433.
31.张子和.《儒门事亲》.人民卫生出版社,2005.P96-98.
32.刘完素.《素问病机气宜保命集》.人民卫生出版社,2005.P2-5.
33.赵估.《圣济总录》.人民卫生出版社,2004.P125-132.
34.马吉华,王新智.赵献可对命门学说的发挥.安徽中医学院学报,1995,3：5-7.
35.赵献可.《医贯》.人民卫生出版社,2005.P74-80.
36.张介宾.《景岳全书》.人民卫生出版社,2005.P165-173.
37.周国琪,陈农.张张景岳治疗老年病特色探析.吉林中医药,1997,13(2)：1-2.
38.胡慎柔.《慎柔五书》.人民卫生出版社,2006.P12-21.
39.虞抟.《医学正传》.中医古籍出版社,2002.P1-12.
40.龚廷贤.《寿世保元》.人民卫生出版社,2005.P25-30.
41.尹东辉,郭丽姓.《寿世保元》对中医老年医学的贡献.上海中医药杂志,2007.41(4)：62-63.
42.李中梓.《医宗必读》.人民卫生出版社,2006.P6-7.
43.李忠业.《医宗必读》治疗老年病学术思想探讨.河南中医,2006,26(3)：22-24.
44.汪绮石.《理虚元鉴》.人民卫生出版社,2006.P8-13.
45.梁慧秋.浅谈汪绮石治虚劳学术思想.世界中医药,2010,5(6)：396.
46.张琳叶,焦振廉.试论《寓意草》的学术特点.江西中医学院学报,2007,19(6)：12-13.
47.喻嘉言.《寓意草》.中国中医药出版社,2008,12.P6.
48.叶天士.《临证指南医案》.人民卫生出版社,2006.P1-22.
49.邓月娥,纪立金.叶天士对中医脾胃学说的贡献.北京中医药大学学报(中医临床版),2009,16(6)：20-22.
50.贾正平.试论“久病人络”理论及临床应用.光明中医,2010,25(8)：1323-1324.
51.吴瑭.《温病条辨》.人民卫生出版社,2005.P7-27,151-176.
52.吴瑭.《吴鞠通医案》.上海科学技术出版社,2010.P20-30.
53.陈士铎.《辨证录》.中国中医药出版社,2007.P148-151.
54.包祖晓,唐启盛.陈士铎从心肾不交论治神志病.吉林中医药.2007,27(5)：1-2.
55.程国彭.《医学心悟》.人民卫生出版社,2006.P5-13.
56.田活.程国彭学术思想探析.辽宁中医药大学学报,2007,9(2)：11-12.
57.方向明.《医学心悟》学术思想探讨.中医文献杂志,2007,(2)：21-24.
58.李知行.徐灵胎“元气存亡论”对中医临床的指导意义.内蒙古中医药,2010,(10)：172.
59.曹庭栋.《老老恒言》.人民卫生出版社,2006.P6.
60.尤乘.《寿世青编》.内蒙古科学技术出版社,2002.P48-49.
61.十清任.《医林改错》.人民卫生出版社,2005.P15-16.
62.欧之洋.《医林改错》对中医老年医学的贡献.河北中医,2006,26(6)：477-478.
1.宋岳涛,杨颖娜.老年病的特点与预防.实用心脑血管病杂志,2008,16(10)：82-84.
2.王发渭,郝爱真.老年人疾病特点和中医用药原则.解放军保健医学杂志,2006,8(1)：54-55.
3.陆惠华.老年病临床特点与对策.中国老年医学杂志,2004,24(2)：173-174.
4.田代华整理.《灵枢经》.人民卫生出版社,2005.P125-137.
5.韩振翔.脾肾在老年病防治中的作用探析.辽宁中医杂志,2004,31(9)：746-747.
6.李君.中医对衰老的认识.黑龙江医学,2005,25(10)：788-190.
7.李旺,张淑萍.岳奏中治疗老年病经验浅谈.江苏中医,2006,27(8)：51-53.
8.吴整军,钱妍.中医对老年病的认识及治疗.中华老年多器官疾病杂,2008,7(3)：254-256.
9.雷晋.老年病从脾论治.中华中医药杂志,2007,22(11)：751-754.
10.王琦.《中医体质学》.北京：人民卫生出版社,2005.P59.
11.多秀瀛.肾虚血瘀是老年病的病理基础浅识.中医药学刊,2005,23(3)524.
12.孟炜.肾虚血瘀导致老年病病理基础浅释.中医药学刊,2001,19(4)：309.
13.魏凤玲.老年病治疗经验浅谈.山西中医,2008,24(2)：49.
14.张莉莉.杜家经治疗老年病经验探析.江西中医药,2001,32(3)：7-8.
15.于格.略论老年虚证.江苏中医,2001,22(8)：1-3.
16.梁光宇,吴绪祥.赵树森主任医师抗衰老学术思想简介.中华中医药学刊,2007,25(8)：1556-1557.
17.冀敦福,季海刚.关于衰老与老年病中医机制的探讨.天津中医学院学报,2004，23(4)169-173.
18.叶丹.基于数据挖掘技术的朱建贵从脾肾论治老年病经验研究.中国医药导刊,2009,11(1)：1-3.
19.李玉清.老年虚证特点与防病延年.山东中医杂志,1996,15(1)：3.
20.张晓峰.老年人体质特点及用药规律考释.中医药学刊,2001,18(3)：239.
21.夏翔,钱永益,丁钰熊,等.1100例老年人的“四诊”调查分析.中医药学报,1985,(1)：24.
22.徐俊伟,苏楠,秦宁.钱海凌教授治疗老年高血压病上盛下虚证经验总结.四川中医,2008,26(4)：5-7.
23.支艳.补肾活血法治疗老年病临床应用.中国中医急诊,2009,18(11)：1822-1823.
24.孙英新.定眩降压合剂治疗老年高血压病的临床观察.山东中医药大学学报,2004，28(1)：51-53.
25.马毓俊.老年性忧郁症从肾论治.上海中医药杂志,2009,41(5)：33-35.
26.陈彦文,工萍,周瑞珍.岭南名医梁剑波治疗老年病学术思想和经验.中华中医药杂志,2005,20(12)：732-734.
27.周琴.健脾补肾理气活血法治疗慢性萎缩性胃炎56例.四川中医,2003,21(3)：43.
28.罗小玲,钟紫茹,江波,等.健脾、补肾方药对绝经后妇女骨质疏松症69例临床观察.医学理论与实践,2008,21(1)：64-65.
29.董翠红,梁娟.健脾补肾法治疗老年性糖尿病30例.山东中医杂志,2006,25(9)：610-611.
30.傅春梅.论肾为老年失眠病机的核心.北京中医药大学学报,2007,30(12)：808-809.
31.孙元莹,吴深涛,王暴魁.张琪教授治疗老年病经验介绍.时珍国医国药,2007，18(6)：1527-1528.
[1]翁维良.社区医疗从书·老年病分册.北京：中国医药科技出版社2005.P7-10.
[2]王长松.当代老年病病证特点及对策.辽宁中医杂志2005,32(12)1249-1250.
[3]吴整军,钱妍.中医对老年病的认识及治疗[J].中华老年多器官疾病杂志,2008,7(3)：254-256.
[4]李呆.《脾胃论》.中国中医药出版社,2007.P1-5.
[5]陈直.《养老奉亲书》.人民卫生出版社,2007.P3-11.
[6]龚廷贤.《寿世保元》.人民卫生出版社,2005.P25-30.
[7]林上助.中医升降理论及治疗大法临床应用体会.中华中医药学会脾胃病分会第二十次全国脾胃病学术交流会论文汇编,2008,9：483-485.
[8]叶天士.《临证指南医案》.人民卫生出版社,2006.P1-22.
[9]朱震亨.《丹溪心法》.人民卫生出版社,2005.P4-5.
[10]张介宾.《景岳全书》.人民卫生出版社,2005.P165-173.
[11]赵献可.《医贯》.人民卫生出版社,2005.P74-80.
[12]陈士铎.《石室秘录》.人民卫生出版社,2006.P52-60.
[13]孙佳,潘桂娟.对陈士铎痰证诊疗思想的探讨,中国中医基础医学杂志,2007,13(5)：375-377.
[14]黄芝蓉,黄继荣.老年病虚实夹杂病机及证治特点探讨,新中医,2001,33(3)：6-8.
[15]韩振翔,刘跃光.脾肾在老年病防治中的作用探析,辽宁中医杂志,2009,31(4)746-748
1.陈钢,李平.数据录入软件EpiData中国医院统计,2006,13(1)：91-93.
2.田琳,闫英杰,朱建贵等.整理挖掘名老中医诊疗眩晕病辨证思维模式的思路与探讨.中国中医基础医学杂志,2006,12(8)：618-620.
3.陈建新,陈静,西广成,等.复杂系统熵聚堆算法及其在中风病临床的应用.系统仿真学报,2008,20(15)：4155-4162.
4.史成和,王秀娟,赵宇昊,等.运用复杂系统熵聚类技术探讨高忠英治疗慢性呼吸系统疾病经验.中医杂志,2010,51(3)：268-270.
5.王映辉,张润顺,吴洁,等.名老中医经验传承研究模式探索[J].中国中医基础医学杂志,2008,14(6)：417-418.
6.东颖,曹莉,韩佩玉.中药药对研究现状概况.深圳中西医结合杂志,2005,15(6)：380-381
2.袁立人.《中医老年学》.上海：上海中医学院出版社,1992.P10-16.
3.张瞥.《实用中医老年病学》.人民军医出版社,2000.P2-7.
4.田代华整理.《黄帝内经·素问》.人民卫生出版社,2005.P1-3.
5.田代华整理.《灵枢经》.人民卫生出版社,2005.P125-137.
6.田金洲.《中医老年病学》.天津科学技术出版社,1994.P12-15.
7.梁光宇,吴绪祥.赵树森主任医师抗衰老学术思想简介.中华中医药学刊,2007：25(8)：1556-1557.
8.冀敦福,季海刚.衰老与老年病中医机制的探讨.天津中医学院学报,2004：23(4)：169-172.
9.韩振翔.脾肾在老年病防治中的作用探析.辽宁中医杂志,2004：31(9)：746-747.
10.魏敏.浅谈祖国医学对老年病的防治.中国实用医药,2009：4(29)：193-194.
11.王洪蓓,傅延龄.略论气机升降学说.中国老年保健医学,2006：4(1)：45-47.
12.应道祺.论升降出入无器不有.中医药通报,2007：6(1)：44-47.
13.蒋峰.浅谈《内经》中的升降理论.四川中医,2006：24(11)：33-34.
14.邓华亮,王玉娟.试论气机升降.辽宁中医药大掌学报,2008：10(7)：36-37.
15.张仲景.《金匮要略》.人民卫生出版社,2005.P4-5.
16.刘汴生,张思雄.《实用临床老年病学》.中国医药科技出版社,2001.P10-12.
17.王莉.葛洪养生思想探析.江西中医药,1996,28(6)：24-26.
18.陶弘景.《养性延命录》.内蒙古科学技术出版社,2002.P2-7.
19.张贤媛.中医老年病学.上海科学技术出版社,1992.P4-9.
20.巢元方.《诸病源候论》.人民军医出版社,2006.P27-28.
21.孙思邈.《千金翼方》.山西科学技术出版社,2010.P140-149.
22.马术明.孙思邈的养生观及其对现代中老年疾病防治的指导意义.河北中医,2010,29(11)：1120-1121.
23.李志更,冯岩.陈直《养老奉亲书》的学术思想与特色.吉林中医药,2011，31(6)：596-598.
24.陈直.《养老奉亲书》.人民卫生出版社,2007.P3-11.
25.李杲.《兰室秘藏》.中国中医药出版社,2007.P1-3.
26.李杲.《脾胃论》.中国中医药出版社,2007.P1-5.
27.雷晋,十波,邢湘君.老年病从脾论治.中华中医药杂志,2007,22(11)：751-754.
28.朱震亨.《丹溪心法》.人民卫生出版社,2005.P4-5.
29.朱震亨.《格致余论》.人民卫生出版社,2005.P2-3.
30.李航,杨少山.杨少山临床诊治经验拾.广州中医药大学学报,2007,24(5)：430-433.
31.张子和.《儒门事亲》.人民卫生出版社,2005.P96-98.
32.刘完素.《素问病机气宜保命集》.人民卫生出版社,2005.P2-5.
33.赵估.《圣济总录》.人民卫生出版社,2004.P125-132.
34.马吉华,王新智.赵献可对命门学说的发挥.安徽中医学院学报,1995,3：5-7.
35.赵献可.《医贯》.人民卫生出版社,2005.P74-80.
36.张介宾.《景岳全书》.人民卫生出版社,2005.P165-173.
37.周国琪,陈农.张张景岳治疗老年病特色探析.吉林中医药,1997,13(2)：1-2.
38.胡慎柔.《慎柔五书》.人民卫生出版社,2006.P12-21.
39.虞抟.《医学正传》.中医古籍出版社,2002.P1-12.
40.龚廷贤.《寿世保元》.人民卫生出版社,2005.P25-30.
41.尹东辉,郭丽姓.《寿世保元》对中医老年医学的贡献.上海中医药杂志,2007.41(4)：62-63.
42.李中梓.《医宗必读》.人民卫生出版社,2006.P6-7.
43.李忠业.《医宗必读》治疗老年病学术思想探讨.河南中医,2006,26(3)：22-24.
44.汪绮石.《理虚元鉴》.人民卫生出版社,2006.P8-13.
45.梁慧秋.浅谈汪绮石治虚劳学术思想.世界中医药,2010,5(6)：396.
46.张琳叶,焦振廉.试论《寓意草》的学术特点.江西中医学院学报,2007,19(6)：12-13.
47.喻嘉言.《寓意草》.中国中医药出版社,2008,12.P6.
48.叶天士.《临证指南医案》.人民卫生出版社,2006.P1-22.
49.邓月娥,纪立金.叶天士对中医脾胃学说的贡献.北京中医药大学学报(中医临床版),2009,16(6)：20-22.
50.贾正平.试论“久病人络”理论及临床应用.光明中医,2010,25(8)：1323-1324.
51.吴瑭.《温病条辨》.人民卫生出版社,2005.P7-27,151-176.
52.吴瑭.《吴鞠通医案》.上海科学技术出版社,2010.P20-30.
53.陈士铎.《辨证录》.中国中医药出版社,2007.P148-151.
54.包祖晓,唐启盛.陈士铎从心肾不交论治神志病.吉林中医药.2007,27(5)：1-2.
55.程国彭.《医学心悟》.人民卫生出版社,2006.P5-13.
56.田活.程国彭学术思想探析.辽宁中医药大学学报,2007,9(2)：11-12.
57.方向明.《医学心悟》学术思想探讨.中医文献杂志,2007,(2)：21-24.
58.李知行.徐灵胎“元气存亡论”对中医临床的指导意义.内蒙古中医药,2010,(10)：172.
59.曹庭栋.《老老恒言》.人民卫生出版社,2006.P6.
60.尤乘.《寿世青编》.内蒙古科学技术出版社,2002.P48-49.
61.十清任.《医林改错》.人民卫生出版社,2005.P15-16.
62.欧之洋.《医林改错》对中医老年医学的贡献.河北中医,2006,26(6)：477-478.
1.宋岳涛,杨颖娜.老年病的特点与预防.实用心脑血管病杂志,2008,16(10)：82-84.
2.王发渭,郝爱真.老年人疾病特点和中医用药原则.解放军保健医学杂志,2006,8(1)：54-55.
3.陆惠华.老年病临床特点与对策.中国老年医学杂志,2004,24(2)：173-174.
4.田代华整理.《灵枢经》.人民卫生出版社,2005.P125-137.
5.韩振翔.脾肾在老年病防治中的作用探析.辽宁中医杂志,2004,31(9)：746-747.
6.李君.中医对衰老的认识.黑龙江医学,2005,25(10)：788-190.
7.李旺,张淑萍.岳奏中治疗老年病经验浅谈.江苏中医,2006,27(8)：51-53.
8.吴整军,钱妍.中医对老年病的认识及治疗.中华老年多器官疾病杂,2008,7(3)：254-256.
9.雷晋.老年病从脾论治.中华中医药杂志,2007,22(11)：751-754.
10.王琦.《中医体质学》.北京：人民卫生出版社,2005.P59.
11.多秀瀛.肾虚血瘀是老年病的病理基础浅识.中医药学刊,2005,23(3)524.
12.孟炜.肾虚血瘀导致老年病病理基础浅释.中医药学刊,2001,19(4)：309.
13.魏凤玲.老年病治疗经验浅谈.山西中医,2008,24(2)：49.
14.张莉莉.杜家经治疗老年病经验探析.江西中医药,2001,32(3)：7-8.
15.于格.略论老年虚证.江苏中医,2001,22(8)：1-3.
16.梁光宇,吴绪祥.赵树森主任医师抗衰老学术思想简介.中华中医药学刊,2007,25(8)：1556-1557.
17.冀敦福,季海刚.关于衰老与老年病中医机制的探讨.天津中医学院学报,2004，23(4)169-173.
18.叶丹.基于数据挖掘技术的朱建贵从脾肾论治老年病经验研究.中国医药导刊,2009,11(1)：1-3.
19.李玉清.老年虚证特点与防病延年.山东中医杂志,1996,15(1)：3.
20.张晓峰.老年人体质特点及用药规律考释.中医药学刊,2001,18(3)：239.
21.夏翔,钱永益,丁钰熊,等.1100例老年人的“四诊”调查分析.中医药学报,1985,(1)：24.
22.徐俊伟,苏楠,秦宁.钱海凌教授治疗老年高血压病上盛下虚证经验总结.四川中医,2008,26(4)：5-7.
23.支艳.补肾活血法治疗老年病临床应用.中国中医急诊,2009,18(11)：1822-1823.
24.孙英新.定眩降压合剂治疗老年高血压病的临床观察.山东中医药大学学报,2004，28(1)：51-53.
25.马毓俊.老年性忧郁症从肾论治.上海中医药杂志,2009,41(5)：33-35.
26.陈彦文,工萍,周瑞珍.岭南名医梁剑波治疗老年病学术思想和经验.中华中医药杂志,2005,20(12)：732-734.
27.周琴.健脾补肾理气活血法治疗慢性萎缩性胃炎56例.四川中医,2003,21(3)：43.
28.罗小玲,钟紫茹,江波,等.健脾、补肾方药对绝经后妇女骨质疏松症69例临床观察.医学理论与实践,2008,21(1)：64-65.
29.董翠红,梁娟.健脾补肾法治疗老年性糖尿病30例.山东中医杂志,2006,25(9)：610-611.
30.傅春梅.论肾为老年失眠病机的核心.北京中医药大学学报,2007,30(12)：808-809.
31.孙元莹,吴深涛,王暴魁.张琪教授治疗老年病经验介绍.时珍国医国药,2007，18(6)：1527-1528.
[1]翁维良.社区医疗从书·老年病分册.北京：中国医药科技出版社2005.P7-10.
[2]王长松.当代老年病病证特点及对策.辽宁中医杂志2005,32(12)1249-1250.
[3]吴整军,钱妍.中医对老年病的认识及治疗[J].中华老年多器官疾病杂志,2008,7(3)：254-256.
[4]李呆.《脾胃论》.中国中医药出版社,2007.P1-5.
[5]陈直.《养老奉亲书》.人民卫生出版社,2007.P3-11.
[6]龚廷贤.《寿世保元》.人民卫生出版社,2005.P25-30.
[7]林上助.中医升降理论及治疗大法临床应用体会.中华中医药学会脾胃病分会第二十次全国脾胃病学术交流会论文汇编,2008,9：483-485.
[8]叶天士.《临证指南医案》.人民卫生出版社,2006.P1-22.
[9]朱震亨.《丹溪心法》.人民卫生出版社,2005.P4-5.
[10]张介宾.《景岳全书》.人民卫生出版社,2005.P165-173.
[11]赵献可.《医贯》.人民卫生出版社,2005.P74-80.
[12]陈士铎.《石室秘录》.人民卫生出版社,2006.P52-60.
[13]孙佳,潘桂娟.对陈士铎痰证诊疗思想的探讨,中国中医基础医学杂志,2007,13(5)：375-377.
[14]黄芝蓉,黄继荣.老年病虚实夹杂病机及证治特点探讨,新中医,2001,33(3)：6-8.
[15]韩振翔,刘跃光.脾肾在老年病防治中的作用探析,辽宁中医杂志,2009,31(4)746-748
1.陈钢,李平.数据录入软件EpiData中国医院统计,2006,13(1)：91-93.
2.田琳,闫英杰,朱建贵等.整理挖掘名老中医诊疗眩晕病辨证思维模式的思路与探讨.中国中医基础医学杂志,2006,12(8)：618-620.
3.陈建新,陈静,西广成,等.复杂系统熵聚堆算法及其在中风病临床的应用.系统仿真学报,2008,20(15)：4155-4162.
4.史成和,王秀娟,赵宇昊,等.运用复杂系统熵聚类技术探讨高忠英治疗慢性呼吸系统疾病经验.中医杂志,2010,51(3)：268-270.
5.王映辉,张润顺,吴洁,等.名老中医经验传承研究模式探索[J].中国中医基础医学杂志,2008,14(6)：417-418.
6.东颖,曹莉,韩佩玉.中药药对研究现状概况.深圳中西医结合杂志,2005,15(6)：380-381