关于广州地区名中医验方的调查与整理研究
|
摘要
研究目的
广州是岭南地域核心城市,广州地区著名中医学术经验,既源自于传统中医药学学术体系,也是岭南历代医家长期与疾病作斗争的经验结晶。广州地区著名中医在对当地人民的生存和繁衍作出不可磨灭的贡献过程中,也留下了反映他们学术经验的重要载体——治病验方。对这些验方进行发掘收集调查整理研究,是传承与发扬岭南地域医学乃至传统中医药学不可缺少的重要组成部分。本论文研究目的意义在于此,即旨在抢救和继承名老中医学术经验,研究和发挥区域中医药资源优势和临床特色,为广州地区名老中医验方的开发利用、推广应用提供理论与实践的依据。
研究方法
本论文注重顶层设计。首先是关于广州地区“名医”概念与“验方”界定。名医是一个时期中医学术和临床疗效水平的主要体现者,本论文研究的“名老中医”以及“名中医”的称谓以政府命名为依据,初步统计有177人,涵盖1979年以前省市确定的名中医、1991年以来卫生部、人事部、国家中管局确定的三批老中医药专家以及广东省确定的两批名中医。验方则是指经临床检验应用有效的药方,其出自名医本人在长期临证实践中,运用中医学理论指导形成的学术经验结晶,它有着坚实的理论基础并经长期临床验证,有着较高的实用价值和广阔的应用前景,可以区别于民间的偏方或古代医书上的流传方。具体研究方法有：
公文征集法。关于广州地区“名医”概念与“验方”界定,为政府部门以公文征集名医验方方式提供保证。通过有关部门的组织协调,以各大院校和医院为依托,向名医本人及其有直接师承关系的后人发稿征集以确保收集资料的可靠性,公文征集是本论文最主要的研究方法之一。
采访调查法。公文征集得到的验方有局限性,名医验方研究必须进行采访调查,本论文验方来源有直接采访名医其本人获取,对已去世的名医,则采访调查其亲属后人以及有直接师承关系的弟子,并辅以座谈、采访、录像、查阅有关资料等多种形式结合,力图以验方为主的形式反映名医学术经验。
发掘收集法。重点对1978年以前的名老中医,难以用公文征集方式取得验方者,则需发掘他们宝贵经验,以收集资料为主方式,在中山文献馆和医院的档案室、病案室、院史馆等部门,内容包括年谱、文物、医案、医话、验方、治法等,力图全面反映名医学术经验。
归类整理法。主要是对验方文献按照学科病种进行整理与归类,收录入合理验方,剔除部分缺乏把握者。这次调研中,所收集到的反映其学术经验的资料主要是名医所编的讲义、讲稿、专著,这部分验方资料大部分被保留。
统计分析法。验方药物的统计分析使用spss13.0进行数据管理,对精选的709首内服验方的药物信息以0、1为代码录入电脑,使用频数分析、聚类分析等方法提取药物信息。包括内科各系统病证和常见病多发病用药统计分析。
验方评述法。对名医验方的组成、验方学术渊源、验方的理论基础、验方的运用经验作简要评述与分析,通过验方评述对广州地区名中医理论学说进行凝练,总结名医的学术经验与临证特点。
按照以上研究方法最后形成学位论文,本论文共整理出验方884首,其中内服验方709首,外治方93首,食疗保健方69首,院内制剂13首。研究结果
论文分为两个部分。第一部分是关于广州地区名中医验方的调研与整理概况,重点收集整理出134位广州地区名老中医的相关资料,其中有验方资料的88位,具体情况如下：①“广州中医药大学名中医验方的调查研究”已完成刘赤选(10首)、邓铁涛(79首)、赵思兢(76首)、沈炎南(26首)、何竹林(20首)、关汝耀(3首)、林建德(3首)、钟耀奎(9首)、陶葆荪(6首)、周子容(2首)、李仲守(1首)、刘庆思(1首)、关济民(1首)、李耀芝(1首)14人,共237首验方；②“广州中医药大学一附院名中医验方的调查研究”已完成罗元恺(39首)、刘仕昌(18首)、黄耀燊(11首)、杨志仁(20首)、蔡荣(2首)、何志雄(1首)、黎炳南(19首)、王德鉴(9首)、周岱翰(8首)、刘亦选(2首)、欧阳惠卿(1首)、熊曼琪(1首)、丘和明(2首)、王士贞(1首)、陈纪藩(2首)、陈镜合(3首)、崔学教(1首)、刘国普(1首)、许鑫梅(1首)19人,共160首验方；③“广东省中医院名中医验方的调查研究”已完成张阶平(107首)、文子源(10首)、岑鹤龄(13首)、甄梦初(17首)、梁乃津(23首)、林夏泉(6首)、刘茂才(1首)、余绍源(6首)、黄春林(2首)、刘伟胜(8首)、梁冰(8首)、李丽芸(4首)、张梅芳(5首)、邓晋丰(5首)、榻国维(2首)、罗笑容(2首)16人,共217首验方；④“广州市中医院名中医验方的调查研究”已完成吴灼燊(6首)、郭梅峰(9首)、区少章(6首)、罗广荫(3首)、刘惠纯(1首)、杨干潜(1首)、刘恩祺(2首)、何广贤(2首)、吴维城(4首)9人,共34首验方；⑤“广东省人民医院名中医验方的调查研究”已完成陈治平(93首)、李钰琳(13首)、黎达英(1首)、周伯康(4首)、黄松柏(2首)、卢宗强(6首)、邱志楠(5首)7人,共214首验方；⑥“中山大学名中医验方的调查研究”已完成黄火文(5首)、罗致强(17首)、李俊彪(3首)、董岳琳(2首)、潘静江(1首)、黄省三(10首)6人,共38首验方；⑦“广东省第二中医院名中医验方的调查研究”已完成邱健行(10首)、卢桂梅(6首)、钟玉池(13首)、胡肇基(11首)4人,共40首验方；⑧“暨南大学名中医验方的调查研究”已完成沈英森(7首)、蔡康保(3首)、汤国杰(1首)3人,共11首验方；⑨“广州市荔湾区名中医验方的调查研究”已完成郭兆仪(5首)、梁天照(2首)、梁端侪(1首)、区金浦(2首)、杜蔚文(1首)5人,共11首验方。
本论文共整理出验方884首,其中内服验方709首,外治方93首,食疗保健方69首,院内制剂13首,形成40余万字的《广州地区名中医验方精选》(详见资料附篇)。内服验方涉及内科、外科、妇科、儿科、五官科、骨伤科以及温病等7个专科,总计126个病证。其中内科验方444首,涉及47个病证,包括肺系病证(57首,6个病证)、心系病证(38首,6个病证)、脾胃系病证(67首,9个病证)、肝胆病证(128首,10个病证)、肾系病证(47首,5个病证)、气血津液病证(59首,6个病证)、肢体经络病证(46首,5个病证)；外科验方有49首,分为5大类19个病证；妇科验方有56首,分为5大类19个病证；儿科验方有52首,包括15个病证；五官验方有50首,分为4大类病的20个病证；骨伤验方有17首,分为3大类病证；温病验方有43首,分为3大类病证。
第二部分是广州地区名中医验方的研究评析,包括验方的药物统计分析和学术评述。广州地区名中医验方的药物统计分析,709首内服方共涉及药物553味,岭南中草药401味,广州地区名医用药重健脾祛湿化痰,清热凉血养阴,喜用岭南中草药,重视五脏辨证。
五脏系统病证的用药统计分析得出：①肺系病证治疗时以止咳化痰平喘为主,辅以宣肺解表,益气养阴,止血；久病加用益气养阴、补肺滋肾之品。②心系病证采用攻补兼施,标本同治的原则,化痰祛瘀同补益气阴相互配合。用药以健脾益气养阴、活血化痰为主。③脾胃系病证常肝胃同治,健脾益气同理气养阴并举,润燥结合、升降相唯、清养并用。用药以理气止痛为主,辅以养阴生津、健脾益气。④肝胆病证以补养肝肾之阴,扶脾益气为根本,佐以平肝潜阳、清热燥湿；用药多和剂,调和肝脾,而理气和血、养阴益气、清热燥湿药要配合使用,润燥结合。⑤肾系病证治疗上攻补兼施,清补兼用,用药以健脾补肾,清热利尿为根本,’佐以益气活血,解毒止血。使不燥不寒,泻中有补,寓补于泻,相辅相成,共奏其效。
广州地区名中医在辨治常见病多发病时,也已经形成了一定的规律性：①治疗咳嗽常止咳化痰平喘并举；具体治疗时,止咳常宣降结合,化痰多以温化为主配合清热化痰,久病累及脾肾应肺脾肾兼顾。②胃痛的治疗上常疏肝和胃、健脾养胃并举、气阴两顾,存在“肝脾同治,脾胃分治,重在调气”的特点,并注意饮食调养。③积聚治当扶正祛邪、标本兼顾。用药以健脾益气除湿,滋阴行血理气为主,且活血通络与滋阴养血理气药常配合使用。④辨治淋证多从脾虚湿盛,湿热蕴结,气滞血瘀入手,实证用药以清利湿热或疏肝理气,消瘀化石为主；虚证多以气虚为主,治宜健脾益气,兼能利湿。⑤癌病治疗上养阴救液以治其本,攻毒散结以治其标；扶正与祛邪,辨病与辨证相结合。⑥痹证以驱风祛湿,滋补肝肾为基本大法,善用藤类和虫类药祛风湿、通络宣痹。
研究结论
本论文首次系统对广东省广州市政府部门所授予的省市级名(老)中医的验方资料进行调研和整理汇编,共整理出88位名(老)中医的884首验方,并按照临床学科以及病种分类,形成《广州地区名中医验方精选》,是为创新点之一。精选之验方,虽未能全面反映广州地区名医临证用药丰富学术经验,但观一斑足以窥全豹,也反映广州地区名医临证善于辨别外感热病与内伤杂病,注意岭南地理炎热潮湿气候环境,结合人体气阴相对不足禀赋素质,善于应用地方中草药材。处方用药治则,或清热凉血解毒,或健脾祛湿化痰,或益气养阴滋肾,或养肝护心理肺,或调理气血疏通经络,或通利并重攻补兼施,名医验方为广州民众医疗卫生保健作出不可磨灭的贡献。
本论文创新点之二,从中医五脏系统辨证用药角度对名医内服验方进行药物统计分析和学术特点评述。认为广州地区名医验方重视五脏辨证,逐渐形成了相对稳定的辨治特色,广州地区名中医验方在学术上具有继承性、区域性、实用性、兼容性及创新性特点。
本研究工作难度大,尚有部分名医的验方资料未完成,后续研究拟在上述工作的基础上,继续更深一步研究,力求最全面整理广州地区名中医验方,并借助数理分析工具,对数据信息进行分析处理,发现疾病与药物、疾病与脏腑的相关性,寻找疾病治疗的共性与特性,为广州地区名老中医验方的开发利用、推广应用提供依据,使之发挥更大的社会效益和经济效益。
Purposes
Guangzhou is the central city of Lingnan region. The experience of prestigious TCM doctors is both from the academic system and long struggling with the disease. The local prestigious TCM doctors make an ineffaceable contribution to Guangzhou people's reproduction and living, during which the prestigious TCM doctors formed the empirical prescriptions as carrier of their experience and academic ideology. The aim and significance of the thesis are saving and inheriting prestigious TCM doctors'experience and academic ideology, studying and developing the advance and uniqueness of local medicine.
Methods
This thesis focuses on top-level design. The first is the conceptualization of "prestigious TCM doctors" and "empirical prescriptions". In this thesis, "senior prestigious TCM doctors" and "prestigious TCM doctors" are according to the official title. By the preliminary statistics, the sum of prestigious TCM doctors is 177, including the "prestigious TCM doctors" titled by province and city governments before 1979, three passels of "senior TCM experts " titled by the Ministry of Health, Ministry of Personnel and State Administration of Traditional Chinese Medicine, two passels of "prestigious TCM doctors" titled by Guangdong province government after 1991. "Empirical prescriptions" are the prescriptions, of which the effects have been proved clinical practice. These prescriptions were the essences of experience and ideology, which formed in the long-time clinical practice of prestigious TCM doctors. Different from the folk prescriptions and ancient prescriptions, empirical prescriptions has solid theoretical foundation, value and expectation of application.
Collecting by official documents:The conceptualization of "prestigious TCM doctors" and "empirical prescriptions" make official administrations can collect empirical prescriptions by official documents. Based on the organization and coordination of official administrations, through related hospitals and school, the author sent the official documents to prestigious TCM doctors or their relatives. This method can ensure the reliability of information, which was the main method in this thesis.
Collecting by interview and survey:Official documents collection has its limitation, therefore interview and survey must be applied as a supplement. The interview and survey come from prestigious TCM doctors or their relatives and disciples. The methods include discussion, interview, video recording and information search, which mainly aims at reflecting prestigious TCM doctors' experience by empirical prescriptions.
Exploratory collection:This method has mainly been used the prestigious TCM doctors titled before 1978, whose empirical prescriptions can not be collected by official documents. This part of the prestigious TCM doctors in the most difficult to obtain prescription solicitation documents. Therefore, the need to collect data based approach to explore their experience. This part of prestigious TCM doctors of the information in the Document Center and Sun Yat-sen Hospital archives, medical record room, hospital and other Historical collection. Collection includes chronology, cultural, medical case, medical case, prescription, administration law. This law seeks to reflect the adoption of a comprehensive academic experience famous doctor.
Classify method:This method is mainly for prescription documentation in accordance with the discipline to organize and classify disease, and prescription and remove some of your lack of a reasonable person to grasp. The investigation and study, the collected data reflect the academic experience famous doctor mainly compiled by prestigious TCM doctors handouts, lectures, monographs. This part of the prescription information was largely retained.
Statistical analysis:Statistical analysis of prescription drug use spss13.0 data management. Oral on the selection of 709 prescription drug information to 0,1 for the code entry computer. Using frequency analysis, cluster analysis, information extraction drugs. This method, including medical evidence, and common diseases of various systems frequently-occurring disease agents statistical analysis.
Recipe Review of method. The composition of the prestigious TCM doctors prescription, prescription of academic origin, the theoretical basis for prescription, prescription and use of experience as a brief review and analysis. Comment by prescription name of the Guangzhou TCM theories were concise, and summarize the academic experience of famous doctors and Clinical Features.
The thesis was formed on the basis of application of the above methods.
Results
The thesis is divided into two parts. The first part is the overview of investigation and arrangement of effective prescriptions from prestigious TCM doctors. This part collected and sorted related data of 134 prestigious TCM doctors in Guangzhou.88 of them have the data about their empirical prescriptions. As follows:①"Investigation and research on prestigious TCM doctors in Guangzhou University of TCM" contained 14 prestigious TCM doctors and 237 empirical prescriptions. Respectively, Liu Chi-xuan (10 prescriptions), Deng Tie-tao (79 prescriptions), Zhao Si-jing (76 prescriptions), Shen Yan-nam (26 prescriptions), He Zhulin (20 prescriptions), Guan Ru-yao (3 prescriptions), Lin Jiande (3 prescriptions), Zhong Yaokui (9 prescriptions), Tao Baosun(6 prescriptions), Zhou Zirong (2 prescriptions), Li Zhongshou (1 prescriptions), Liu Qingsi (1 prescriptions), Guan Ji min (1 prescriptions), Li Yaozhi (1 prescriptions).②"Investigation and research on prestigious TCM doctors in First Affiliated Hospital of Guangzhou University of TCM" contained 19 prestigious TCM doctors and 160 empirical prescriptions. Respectively, Luo Yuankai (39 prescriptions), Liu Shichang (18.prescriptions), Huang Yaoshen (11 prescriptions), Yang Zhiren (20 prescriptions), Cai Rong (2 prescriptions), He Zhixiong (1 prescriptions), Li Bingnan (19 prescriptions), Wang Dejian(9 prescriptions), Zhou Daihan (8 prescriptions), Liu Yixuan (2 prescriptions), OuYang Huiqing (1 prescriptions), Xiong Manqi (1 prescriptions), Qiu Heming (2 prescriptions), Wang Shizhen(1 prescriptions), Chen Jifan(2 prescriptions), Chen Jinghe (3 prescriptions), Cui Xuejiao (1 prescriptions), Liu Guopu (1 prescriptions), Xu Xinmei (1 prescriptions).③"Investigation and research on prestigious TCM doctors in Guangdong Provincial Hospital of TCM" contained 16 prestigious TCM doctors and 217 empirical prescriptions. Respectively, Zhang Jieping (107 prescriptions), Wen Zi yuan (10 prescriptions), CenHeling (13 prescriptions), Zhen Mengchu (17 prescriptions), Liang Naijin (23 prescriptions), Lin Xiaquan (6 prescriptions), LiuMaocai (1 prescriptions), Yu Shaoyuan (6 prescriptions), Huang Chunlin (2 prescriptions), Liu Weisheng (8 prescriptions), Liang Bing(8 prescriptions), Li Liyun (4 prescriptions), Zhang Meifang (5 prescriptions), Deng Jinfeng (5 prescriptions), Xuan Guowei(2 prescriptions), Luo Xiaorong (2 prescriptions).④"Investigation and research on prestigious TCM doctors in Guangzhou city hospital of TCM" contained 9 prestigious TCM doctors and 34 empirical prescriptions. Respectively, Wu Zhuoshen (6 prescriptions), Guo Meifeng (9 prescriptions), Ou Shaozhang (6 prescriptions), Luo Guangyin (3 prescriptions), Liu Huichun (1 prescriptions), Yang Ganqian (1 prescriptions), Liu Enqi (2 prescriptions), He Guangxian (2 prescriptions), Wu Weicheng (4 prescriptions).⑤"Investigation and research on prestigious TCM doctors in Guangdong Provincial People's Hospital" contained 7 prestigious TCM doctors and 214 empirical prescriptions. Respectively, Chen Zhiping(93 prescriptions), Li Yulin (13 prescriptions), Li Daying (1 prescriptions), Zhou Bokang (4 prescriptions), Huang Songbo (2 prescriptions), Lu Zongqiang (6 prescriptions), Qiu Zhinan (5 prescriptions).⑥"Investigation and research on prestigious TCM doctors in Sun Yat-sen University" contained 6 prestigious TCM doctors and 38 empirical prescriptions. Respectively, Huang Huowen(5 prescriptions), Luo Zhiqiang (17 prescriptions), Li Junbiao (3 prescriptions), DongYuelin (2 prescriptions), Pan Jingjiang (1 prescriptions), Huang Shengsan (10 prescriptions).⑦"Investigation and research on prestigious TCM doctors in Guangdong Second Provincial Hospital of TCM" contained 4 prestigious TCM doctors and 40 empirical prescriptions. Respectively, Qiu Jianxing (10 prescriptions), Lu Guimei (6 prescriptions), Zhong Yuchi (13 prescriptions), Hu Zhaoji (11 prescriptions).⑧"Investigation and research on prestigious TCM doctors in Jinan University" contained 3 prestigious TCM doctors and 11 empirical prescriptions. Respectively, Shen Yingsen(7 prescriptions), Cai Kong Bao (3 prescriptions), Tang Guojie(1 prescriptions).⑨"Investigation and research on prestigious TCM doctors in Liwan district hospital of TCM" contained 5 prestigious TCM doctors and 11 empirical prescriptions. Respectively, Guo Zhaoyi (5 prescriptions), Liang Tianzhao (2 prescriptions), Liang Tianzhao (1 prescriptions), Ou Jinpu (2 prescriptions), Du Weiwen (1 prescriptions).
The thesis sorted out 884 empirical prescriptions, about which a 400 thousand word treatise, "The selected empirical prescriptions of prestigious TCM doctors in Guangzhou" was formed, (details of the book were recorded in appendix of thesis). In these 884 empirical prescriptions,709 prescriptions are for internal use,93 prescriptions are for external use,69 prescriptions are for dietetic therapy,13 prescriptions are hospital production. The internal use prescriptions refer to internal medicine, surgery, gynecology, paediatrics, focal illuminator, osteonosus and traumatism, seasonal febrile diseases,7 specialities,126 syndromes.444 internal prescriptions refer to 47 syndromes. For lung system,67 prescriptions refer to 9 syndromes; for heart system,38 prescriptions refer to 6 syndromes; for spleen-stomach system,67 prescriptions refer to 9 syndromes; for liver-gallbladder system,128 prescriptions refer to 10 syndromes; for kidneys system,47 prescriptions refer to 5 syndromes, for qi-blood-fluids system,59 prescriptions refer to 6 syndromes; for membra and meridians system,46 prescriptions refer to 5 syndromes. Prescriptions for surgery contain 49 prescriptions, refer to five kinds of diseases,19 syndromes.56 Gynecology prescriptions refer to five kinds of diseases,19 syndromes.52 paediatrics prescriptions refer to 15 syndromes.50 focal illuminator prescriptions refer to four kinds of diseases, 20 syndromes.17 osteonosus prescriptions refer to three kinds of syndromes. 43 seasonal febrile diseases prescriptions refer to three kinds of syndromes.
The second part is the comments and analysis of the empirical prescriptions, which contains statistical analysis and academic comments. The results of the statistical analysis showed as follows:There are 553 drugs in 709 internal use prescriptions and 403 drugs are local herbal drugs. The medication of prestigious TCM doctors in Guangzhou focus on the methods of clearing heat, cooling blood and nourishing yin, using of herbal drugs and Five-zang syndromes differentiation.
The analysis of medication for Five-zang syndromes showed as follows:①The treatments for lung syndromes mainly use the methods of relieving cough and reducing phlegm, assisted with releasing lung and relieving superficies, supplementing qi and nourishing yin, astringing blood, added with tonifying lung and nourishing kidneys in obstinate diseases.②The treatments for heat syndromes follow the rules of simultaneously application of purging-tonifying therapy and treating both superficiality and origin, take the combination of removing blood stasis, reducing phlegm, and nourishing qi-yin, mainly use the drugs of invigorating spleen, supplementing qi, nourishing yin, promoting blood flow and reducing phlegm.③The treatments for spleen-stomach syndromes usually treat both liver and stomach, mainly simultaneously use the methods of invigorating spleen to supplement qi and regulating qi to nourish yin, mainly use the drugs of regulating qi to alleviate pain, assisted with nourishing to produce body fluids.④The treatments for liver-gallbladder syndromes base on the nourishing yin of liver and kidneys and invigorating spleen to supplement qi, assisted with calming the liver and suppressing yang, clearing heat and drying dampness, mainly use the drugs of regulating liver and spleen.⑤The treatments for kidneys syndromes follow the rules of simultaneously application of purging-tonifying therapy and treating both superficiality and origin, base on invigorating spleen and tonifying kidneys, reducing fever to induce urination, assisted supplementing qi to promote blood flow, detoxicating and astringing blood. The characteristic is tonification involving purgation.
There are some rules reflected in the prestigious TCM doctors'treatment for some common diseases.①The treatments for cough usually simultaneously use relieving cough, reducing phlegm and relieving asthma. The method of relieving cough is usually the combination of dispersing and descending. Reducing phlegm usually takes the methods of warmly dissipation, assisted with clearing heat.②The treatments for stomach-ache usually are dispersing the depressed liver-qi to regulate stomach, invigorating spleen and nourish spleen, simultaneously protecting qi and yin. The characteristics of prestigious TCM doctors are treating both liver and stomach, separately treating spleen and stomach, focusing on regulating qi and dieting therapy.③The treatments for abdominal mass follow the rules of strengthening healthy qi to eliminate pathogens and treating both superficiality and origin. The prestigious TCM doctors mainly use the combination of promoting blood flow to dredge meridians and supplementing yin to nourish blood.④Prestigious TCM doctors treat stranguria from the dampness abundance due to spleen deficiency and damp-heat gluing and blood stasis due to qi stagnancy, and use clearing heat and eliminating dampness, dispersing depressed liver-qi to regulate qi, clearing blood stasis and removing urinary calculus.⑤In the treatment of cancer, the prestigious TCM doctors treat symptoms by conteracting toxic and eliminating stasis, treat origin by nourishing yin and body fluids.⑥The prestigious TCM doctors'basic treatments for Bi syndrome are dispelling wind and dampness, nourishing liver and kidneys, they also be skilled in using vines, arthropods to eliminate wind and dredge meridians.
Conclusions
The thesis is the first time to investigate and arrange the empirical prescriptions of prestigious TCM doctors who were titled by Guangdong and Guangzhou government. The thesis sorted out 884 empirical prescriptions of 88 prestigious TCM doctors and formed "The selected empirical prescriptions of prestigious TCM doctors in Guangzhou". Above is the first innovation Although the selected prescriptions did not reflect the prestigious TCM doctors'experience from every aspect, they did reflect the uniqueness of clinical practice of prestigious TCM doctors in Guangdong, such as effective differentiation between cold attack diseases and seasonal febrile disease, attention to the hot and humid climate in Lingnan region, using local herbal medicine for qi-yin-deficiency constitution of local people, medication rules of removing heat to cool blood and detoxicate, invigorating spleen to remove phlegm, supplementing qi and nourish yin to nourish kidneys, simultaneously treatment for liver-heart-lung, regulating qi and blood to dredge meridians, simultaneously application of purging-tonifying therapy. The empirical prescriptions make a indelible contribute to the health care of Guangzhou people.
The second innovation is commenting and statistically analysing the internal prescriptions on the basis of Five-zang syndromes differentiation. The results showed that prestigious TCM doctors in Guangzhou focus on Five-zang syndromes differentiation and have obvious characteristics of clinical diagnosis and treatment. The empirical prescriptions of prestigious TCM doctors have inheritability, regional characteristic, practicability, compatibility and innovation.
This research is a difficult work, pat of which is still unfinished. The follow-up deeper study aims at sorting empirical prescriptions of prestigious TCM doctors in Guangzhou from wilder scope on the basis of finished study. The future work will focus on analyzing the data by mathematics analysis tool, which aims at discovering the correlation between diseases and drugs, diseases and Zang-fu organs, and finding the generality and speciality among treatments. This work will provide a basis for the promotion and development of empirical prescriptions of prestigious TCM doctors and explore their economic benefits and social benefits.
广州是岭南地域核心城市,广州地区著名中医学术经验,既源自于传统中医药学学术体系,也是岭南历代医家长期与疾病作斗争的经验结晶。广州地区著名中医在对当地人民的生存和繁衍作出不可磨灭的贡献过程中,也留下了反映他们学术经验的重要载体——治病验方。对这些验方进行发掘收集调查整理研究,是传承与发扬岭南地域医学乃至传统中医药学不可缺少的重要组成部分。本论文研究目的意义在于此,即旨在抢救和继承名老中医学术经验,研究和发挥区域中医药资源优势和临床特色,为广州地区名老中医验方的开发利用、推广应用提供理论与实践的依据。
研究方法
本论文注重顶层设计。首先是关于广州地区“名医”概念与“验方”界定。名医是一个时期中医学术和临床疗效水平的主要体现者,本论文研究的“名老中医”以及“名中医”的称谓以政府命名为依据,初步统计有177人,涵盖1979年以前省市确定的名中医、1991年以来卫生部、人事部、国家中管局确定的三批老中医药专家以及广东省确定的两批名中医。验方则是指经临床检验应用有效的药方,其出自名医本人在长期临证实践中,运用中医学理论指导形成的学术经验结晶,它有着坚实的理论基础并经长期临床验证,有着较高的实用价值和广阔的应用前景,可以区别于民间的偏方或古代医书上的流传方。具体研究方法有：
公文征集法。关于广州地区“名医”概念与“验方”界定,为政府部门以公文征集名医验方方式提供保证。通过有关部门的组织协调,以各大院校和医院为依托,向名医本人及其有直接师承关系的后人发稿征集以确保收集资料的可靠性,公文征集是本论文最主要的研究方法之一。
采访调查法。公文征集得到的验方有局限性,名医验方研究必须进行采访调查,本论文验方来源有直接采访名医其本人获取,对已去世的名医,则采访调查其亲属后人以及有直接师承关系的弟子,并辅以座谈、采访、录像、查阅有关资料等多种形式结合,力图以验方为主的形式反映名医学术经验。
发掘收集法。重点对1978年以前的名老中医,难以用公文征集方式取得验方者,则需发掘他们宝贵经验,以收集资料为主方式,在中山文献馆和医院的档案室、病案室、院史馆等部门,内容包括年谱、文物、医案、医话、验方、治法等,力图全面反映名医学术经验。
归类整理法。主要是对验方文献按照学科病种进行整理与归类,收录入合理验方,剔除部分缺乏把握者。这次调研中,所收集到的反映其学术经验的资料主要是名医所编的讲义、讲稿、专著,这部分验方资料大部分被保留。
统计分析法。验方药物的统计分析使用spss13.0进行数据管理,对精选的709首内服验方的药物信息以0、1为代码录入电脑,使用频数分析、聚类分析等方法提取药物信息。包括内科各系统病证和常见病多发病用药统计分析。
验方评述法。对名医验方的组成、验方学术渊源、验方的理论基础、验方的运用经验作简要评述与分析,通过验方评述对广州地区名中医理论学说进行凝练,总结名医的学术经验与临证特点。
按照以上研究方法最后形成学位论文,本论文共整理出验方884首,其中内服验方709首,外治方93首,食疗保健方69首,院内制剂13首。研究结果
论文分为两个部分。第一部分是关于广州地区名中医验方的调研与整理概况,重点收集整理出134位广州地区名老中医的相关资料,其中有验方资料的88位,具体情况如下：①“广州中医药大学名中医验方的调查研究”已完成刘赤选(10首)、邓铁涛(79首)、赵思兢(76首)、沈炎南(26首)、何竹林(20首)、关汝耀(3首)、林建德(3首)、钟耀奎(9首)、陶葆荪(6首)、周子容(2首)、李仲守(1首)、刘庆思(1首)、关济民(1首)、李耀芝(1首)14人,共237首验方；②“广州中医药大学一附院名中医验方的调查研究”已完成罗元恺(39首)、刘仕昌(18首)、黄耀燊(11首)、杨志仁(20首)、蔡荣(2首)、何志雄(1首)、黎炳南(19首)、王德鉴(9首)、周岱翰(8首)、刘亦选(2首)、欧阳惠卿(1首)、熊曼琪(1首)、丘和明(2首)、王士贞(1首)、陈纪藩(2首)、陈镜合(3首)、崔学教(1首)、刘国普(1首)、许鑫梅(1首)19人,共160首验方；③“广东省中医院名中医验方的调查研究”已完成张阶平(107首)、文子源(10首)、岑鹤龄(13首)、甄梦初(17首)、梁乃津(23首)、林夏泉(6首)、刘茂才(1首)、余绍源(6首)、黄春林(2首)、刘伟胜(8首)、梁冰(8首)、李丽芸(4首)、张梅芳(5首)、邓晋丰(5首)、榻国维(2首)、罗笑容(2首)16人,共217首验方；④“广州市中医院名中医验方的调查研究”已完成吴灼燊(6首)、郭梅峰(9首)、区少章(6首)、罗广荫(3首)、刘惠纯(1首)、杨干潜(1首)、刘恩祺(2首)、何广贤(2首)、吴维城(4首)9人,共34首验方；⑤“广东省人民医院名中医验方的调查研究”已完成陈治平(93首)、李钰琳(13首)、黎达英(1首)、周伯康(4首)、黄松柏(2首)、卢宗强(6首)、邱志楠(5首)7人,共214首验方；⑥“中山大学名中医验方的调查研究”已完成黄火文(5首)、罗致强(17首)、李俊彪(3首)、董岳琳(2首)、潘静江(1首)、黄省三(10首)6人,共38首验方；⑦“广东省第二中医院名中医验方的调查研究”已完成邱健行(10首)、卢桂梅(6首)、钟玉池(13首)、胡肇基(11首)4人,共40首验方；⑧“暨南大学名中医验方的调查研究”已完成沈英森(7首)、蔡康保(3首)、汤国杰(1首)3人,共11首验方；⑨“广州市荔湾区名中医验方的调查研究”已完成郭兆仪(5首)、梁天照(2首)、梁端侪(1首)、区金浦(2首)、杜蔚文(1首)5人,共11首验方。
本论文共整理出验方884首,其中内服验方709首,外治方93首,食疗保健方69首,院内制剂13首,形成40余万字的《广州地区名中医验方精选》(详见资料附篇)。内服验方涉及内科、外科、妇科、儿科、五官科、骨伤科以及温病等7个专科,总计126个病证。其中内科验方444首,涉及47个病证,包括肺系病证(57首,6个病证)、心系病证(38首,6个病证)、脾胃系病证(67首,9个病证)、肝胆病证(128首,10个病证)、肾系病证(47首,5个病证)、气血津液病证(59首,6个病证)、肢体经络病证(46首,5个病证)；外科验方有49首,分为5大类19个病证；妇科验方有56首,分为5大类19个病证；儿科验方有52首,包括15个病证；五官验方有50首,分为4大类病的20个病证；骨伤验方有17首,分为3大类病证；温病验方有43首,分为3大类病证。
第二部分是广州地区名中医验方的研究评析,包括验方的药物统计分析和学术评述。广州地区名中医验方的药物统计分析,709首内服方共涉及药物553味,岭南中草药401味,广州地区名医用药重健脾祛湿化痰,清热凉血养阴,喜用岭南中草药,重视五脏辨证。
五脏系统病证的用药统计分析得出：①肺系病证治疗时以止咳化痰平喘为主,辅以宣肺解表,益气养阴,止血；久病加用益气养阴、补肺滋肾之品。②心系病证采用攻补兼施,标本同治的原则,化痰祛瘀同补益气阴相互配合。用药以健脾益气养阴、活血化痰为主。③脾胃系病证常肝胃同治,健脾益气同理气养阴并举,润燥结合、升降相唯、清养并用。用药以理气止痛为主,辅以养阴生津、健脾益气。④肝胆病证以补养肝肾之阴,扶脾益气为根本,佐以平肝潜阳、清热燥湿；用药多和剂,调和肝脾,而理气和血、养阴益气、清热燥湿药要配合使用,润燥结合。⑤肾系病证治疗上攻补兼施,清补兼用,用药以健脾补肾,清热利尿为根本,’佐以益气活血,解毒止血。使不燥不寒,泻中有补,寓补于泻,相辅相成,共奏其效。
广州地区名中医在辨治常见病多发病时,也已经形成了一定的规律性：①治疗咳嗽常止咳化痰平喘并举；具体治疗时,止咳常宣降结合,化痰多以温化为主配合清热化痰,久病累及脾肾应肺脾肾兼顾。②胃痛的治疗上常疏肝和胃、健脾养胃并举、气阴两顾,存在“肝脾同治,脾胃分治,重在调气”的特点,并注意饮食调养。③积聚治当扶正祛邪、标本兼顾。用药以健脾益气除湿,滋阴行血理气为主,且活血通络与滋阴养血理气药常配合使用。④辨治淋证多从脾虚湿盛,湿热蕴结,气滞血瘀入手,实证用药以清利湿热或疏肝理气,消瘀化石为主；虚证多以气虚为主,治宜健脾益气,兼能利湿。⑤癌病治疗上养阴救液以治其本,攻毒散结以治其标；扶正与祛邪,辨病与辨证相结合。⑥痹证以驱风祛湿,滋补肝肾为基本大法,善用藤类和虫类药祛风湿、通络宣痹。
研究结论
本论文首次系统对广东省广州市政府部门所授予的省市级名(老)中医的验方资料进行调研和整理汇编,共整理出88位名(老)中医的884首验方,并按照临床学科以及病种分类,形成《广州地区名中医验方精选》,是为创新点之一。精选之验方,虽未能全面反映广州地区名医临证用药丰富学术经验,但观一斑足以窥全豹,也反映广州地区名医临证善于辨别外感热病与内伤杂病,注意岭南地理炎热潮湿气候环境,结合人体气阴相对不足禀赋素质,善于应用地方中草药材。处方用药治则,或清热凉血解毒,或健脾祛湿化痰,或益气养阴滋肾,或养肝护心理肺,或调理气血疏通经络,或通利并重攻补兼施,名医验方为广州民众医疗卫生保健作出不可磨灭的贡献。
本论文创新点之二,从中医五脏系统辨证用药角度对名医内服验方进行药物统计分析和学术特点评述。认为广州地区名医验方重视五脏辨证,逐渐形成了相对稳定的辨治特色,广州地区名中医验方在学术上具有继承性、区域性、实用性、兼容性及创新性特点。
本研究工作难度大,尚有部分名医的验方资料未完成,后续研究拟在上述工作的基础上,继续更深一步研究,力求最全面整理广州地区名中医验方,并借助数理分析工具,对数据信息进行分析处理,发现疾病与药物、疾病与脏腑的相关性,寻找疾病治疗的共性与特性,为广州地区名老中医验方的开发利用、推广应用提供依据,使之发挥更大的社会效益和经济效益。
Purposes
Guangzhou is the central city of Lingnan region. The experience of prestigious TCM doctors is both from the academic system and long struggling with the disease. The local prestigious TCM doctors make an ineffaceable contribution to Guangzhou people's reproduction and living, during which the prestigious TCM doctors formed the empirical prescriptions as carrier of their experience and academic ideology. The aim and significance of the thesis are saving and inheriting prestigious TCM doctors'experience and academic ideology, studying and developing the advance and uniqueness of local medicine.
Methods
This thesis focuses on top-level design. The first is the conceptualization of "prestigious TCM doctors" and "empirical prescriptions". In this thesis, "senior prestigious TCM doctors" and "prestigious TCM doctors" are according to the official title. By the preliminary statistics, the sum of prestigious TCM doctors is 177, including the "prestigious TCM doctors" titled by province and city governments before 1979, three passels of "senior TCM experts " titled by the Ministry of Health, Ministry of Personnel and State Administration of Traditional Chinese Medicine, two passels of "prestigious TCM doctors" titled by Guangdong province government after 1991. "Empirical prescriptions" are the prescriptions, of which the effects have been proved clinical practice. These prescriptions were the essences of experience and ideology, which formed in the long-time clinical practice of prestigious TCM doctors. Different from the folk prescriptions and ancient prescriptions, empirical prescriptions has solid theoretical foundation, value and expectation of application.
Collecting by official documents:The conceptualization of "prestigious TCM doctors" and "empirical prescriptions" make official administrations can collect empirical prescriptions by official documents. Based on the organization and coordination of official administrations, through related hospitals and school, the author sent the official documents to prestigious TCM doctors or their relatives. This method can ensure the reliability of information, which was the main method in this thesis.
Collecting by interview and survey:Official documents collection has its limitation, therefore interview and survey must be applied as a supplement. The interview and survey come from prestigious TCM doctors or their relatives and disciples. The methods include discussion, interview, video recording and information search, which mainly aims at reflecting prestigious TCM doctors' experience by empirical prescriptions.
Exploratory collection:This method has mainly been used the prestigious TCM doctors titled before 1978, whose empirical prescriptions can not be collected by official documents. This part of the prestigious TCM doctors in the most difficult to obtain prescription solicitation documents. Therefore, the need to collect data based approach to explore their experience. This part of prestigious TCM doctors of the information in the Document Center and Sun Yat-sen Hospital archives, medical record room, hospital and other Historical collection. Collection includes chronology, cultural, medical case, medical case, prescription, administration law. This law seeks to reflect the adoption of a comprehensive academic experience famous doctor.
Classify method:This method is mainly for prescription documentation in accordance with the discipline to organize and classify disease, and prescription and remove some of your lack of a reasonable person to grasp. The investigation and study, the collected data reflect the academic experience famous doctor mainly compiled by prestigious TCM doctors handouts, lectures, monographs. This part of the prescription information was largely retained.
Statistical analysis:Statistical analysis of prescription drug use spss13.0 data management. Oral on the selection of 709 prescription drug information to 0,1 for the code entry computer. Using frequency analysis, cluster analysis, information extraction drugs. This method, including medical evidence, and common diseases of various systems frequently-occurring disease agents statistical analysis.
Recipe Review of method. The composition of the prestigious TCM doctors prescription, prescription of academic origin, the theoretical basis for prescription, prescription and use of experience as a brief review and analysis. Comment by prescription name of the Guangzhou TCM theories were concise, and summarize the academic experience of famous doctors and Clinical Features.
The thesis was formed on the basis of application of the above methods.
Results
The thesis is divided into two parts. The first part is the overview of investigation and arrangement of effective prescriptions from prestigious TCM doctors. This part collected and sorted related data of 134 prestigious TCM doctors in Guangzhou.88 of them have the data about their empirical prescriptions. As follows:①"Investigation and research on prestigious TCM doctors in Guangzhou University of TCM" contained 14 prestigious TCM doctors and 237 empirical prescriptions. Respectively, Liu Chi-xuan (10 prescriptions), Deng Tie-tao (79 prescriptions), Zhao Si-jing (76 prescriptions), Shen Yan-nam (26 prescriptions), He Zhulin (20 prescriptions), Guan Ru-yao (3 prescriptions), Lin Jiande (3 prescriptions), Zhong Yaokui (9 prescriptions), Tao Baosun(6 prescriptions), Zhou Zirong (2 prescriptions), Li Zhongshou (1 prescriptions), Liu Qingsi (1 prescriptions), Guan Ji min (1 prescriptions), Li Yaozhi (1 prescriptions).②"Investigation and research on prestigious TCM doctors in First Affiliated Hospital of Guangzhou University of TCM" contained 19 prestigious TCM doctors and 160 empirical prescriptions. Respectively, Luo Yuankai (39 prescriptions), Liu Shichang (18.prescriptions), Huang Yaoshen (11 prescriptions), Yang Zhiren (20 prescriptions), Cai Rong (2 prescriptions), He Zhixiong (1 prescriptions), Li Bingnan (19 prescriptions), Wang Dejian(9 prescriptions), Zhou Daihan (8 prescriptions), Liu Yixuan (2 prescriptions), OuYang Huiqing (1 prescriptions), Xiong Manqi (1 prescriptions), Qiu Heming (2 prescriptions), Wang Shizhen(1 prescriptions), Chen Jifan(2 prescriptions), Chen Jinghe (3 prescriptions), Cui Xuejiao (1 prescriptions), Liu Guopu (1 prescriptions), Xu Xinmei (1 prescriptions).③"Investigation and research on prestigious TCM doctors in Guangdong Provincial Hospital of TCM" contained 16 prestigious TCM doctors and 217 empirical prescriptions. Respectively, Zhang Jieping (107 prescriptions), Wen Zi yuan (10 prescriptions), CenHeling (13 prescriptions), Zhen Mengchu (17 prescriptions), Liang Naijin (23 prescriptions), Lin Xiaquan (6 prescriptions), LiuMaocai (1 prescriptions), Yu Shaoyuan (6 prescriptions), Huang Chunlin (2 prescriptions), Liu Weisheng (8 prescriptions), Liang Bing(8 prescriptions), Li Liyun (4 prescriptions), Zhang Meifang (5 prescriptions), Deng Jinfeng (5 prescriptions), Xuan Guowei(2 prescriptions), Luo Xiaorong (2 prescriptions).④"Investigation and research on prestigious TCM doctors in Guangzhou city hospital of TCM" contained 9 prestigious TCM doctors and 34 empirical prescriptions. Respectively, Wu Zhuoshen (6 prescriptions), Guo Meifeng (9 prescriptions), Ou Shaozhang (6 prescriptions), Luo Guangyin (3 prescriptions), Liu Huichun (1 prescriptions), Yang Ganqian (1 prescriptions), Liu Enqi (2 prescriptions), He Guangxian (2 prescriptions), Wu Weicheng (4 prescriptions).⑤"Investigation and research on prestigious TCM doctors in Guangdong Provincial People's Hospital" contained 7 prestigious TCM doctors and 214 empirical prescriptions. Respectively, Chen Zhiping(93 prescriptions), Li Yulin (13 prescriptions), Li Daying (1 prescriptions), Zhou Bokang (4 prescriptions), Huang Songbo (2 prescriptions), Lu Zongqiang (6 prescriptions), Qiu Zhinan (5 prescriptions).⑥"Investigation and research on prestigious TCM doctors in Sun Yat-sen University" contained 6 prestigious TCM doctors and 38 empirical prescriptions. Respectively, Huang Huowen(5 prescriptions), Luo Zhiqiang (17 prescriptions), Li Junbiao (3 prescriptions), DongYuelin (2 prescriptions), Pan Jingjiang (1 prescriptions), Huang Shengsan (10 prescriptions).⑦"Investigation and research on prestigious TCM doctors in Guangdong Second Provincial Hospital of TCM" contained 4 prestigious TCM doctors and 40 empirical prescriptions. Respectively, Qiu Jianxing (10 prescriptions), Lu Guimei (6 prescriptions), Zhong Yuchi (13 prescriptions), Hu Zhaoji (11 prescriptions).⑧"Investigation and research on prestigious TCM doctors in Jinan University" contained 3 prestigious TCM doctors and 11 empirical prescriptions. Respectively, Shen Yingsen(7 prescriptions), Cai Kong Bao (3 prescriptions), Tang Guojie(1 prescriptions).⑨"Investigation and research on prestigious TCM doctors in Liwan district hospital of TCM" contained 5 prestigious TCM doctors and 11 empirical prescriptions. Respectively, Guo Zhaoyi (5 prescriptions), Liang Tianzhao (2 prescriptions), Liang Tianzhao (1 prescriptions), Ou Jinpu (2 prescriptions), Du Weiwen (1 prescriptions).
The thesis sorted out 884 empirical prescriptions, about which a 400 thousand word treatise, "The selected empirical prescriptions of prestigious TCM doctors in Guangzhou" was formed, (details of the book were recorded in appendix of thesis). In these 884 empirical prescriptions,709 prescriptions are for internal use,93 prescriptions are for external use,69 prescriptions are for dietetic therapy,13 prescriptions are hospital production. The internal use prescriptions refer to internal medicine, surgery, gynecology, paediatrics, focal illuminator, osteonosus and traumatism, seasonal febrile diseases,7 specialities,126 syndromes.444 internal prescriptions refer to 47 syndromes. For lung system,67 prescriptions refer to 9 syndromes; for heart system,38 prescriptions refer to 6 syndromes; for spleen-stomach system,67 prescriptions refer to 9 syndromes; for liver-gallbladder system,128 prescriptions refer to 10 syndromes; for kidneys system,47 prescriptions refer to 5 syndromes, for qi-blood-fluids system,59 prescriptions refer to 6 syndromes; for membra and meridians system,46 prescriptions refer to 5 syndromes. Prescriptions for surgery contain 49 prescriptions, refer to five kinds of diseases,19 syndromes.56 Gynecology prescriptions refer to five kinds of diseases,19 syndromes.52 paediatrics prescriptions refer to 15 syndromes.50 focal illuminator prescriptions refer to four kinds of diseases, 20 syndromes.17 osteonosus prescriptions refer to three kinds of syndromes. 43 seasonal febrile diseases prescriptions refer to three kinds of syndromes.
The second part is the comments and analysis of the empirical prescriptions, which contains statistical analysis and academic comments. The results of the statistical analysis showed as follows:There are 553 drugs in 709 internal use prescriptions and 403 drugs are local herbal drugs. The medication of prestigious TCM doctors in Guangzhou focus on the methods of clearing heat, cooling blood and nourishing yin, using of herbal drugs and Five-zang syndromes differentiation.
The analysis of medication for Five-zang syndromes showed as follows:①The treatments for lung syndromes mainly use the methods of relieving cough and reducing phlegm, assisted with releasing lung and relieving superficies, supplementing qi and nourishing yin, astringing blood, added with tonifying lung and nourishing kidneys in obstinate diseases.②The treatments for heat syndromes follow the rules of simultaneously application of purging-tonifying therapy and treating both superficiality and origin, take the combination of removing blood stasis, reducing phlegm, and nourishing qi-yin, mainly use the drugs of invigorating spleen, supplementing qi, nourishing yin, promoting blood flow and reducing phlegm.③The treatments for spleen-stomach syndromes usually treat both liver and stomach, mainly simultaneously use the methods of invigorating spleen to supplement qi and regulating qi to nourish yin, mainly use the drugs of regulating qi to alleviate pain, assisted with nourishing to produce body fluids.④The treatments for liver-gallbladder syndromes base on the nourishing yin of liver and kidneys and invigorating spleen to supplement qi, assisted with calming the liver and suppressing yang, clearing heat and drying dampness, mainly use the drugs of regulating liver and spleen.⑤The treatments for kidneys syndromes follow the rules of simultaneously application of purging-tonifying therapy and treating both superficiality and origin, base on invigorating spleen and tonifying kidneys, reducing fever to induce urination, assisted supplementing qi to promote blood flow, detoxicating and astringing blood. The characteristic is tonification involving purgation.
There are some rules reflected in the prestigious TCM doctors'treatment for some common diseases.①The treatments for cough usually simultaneously use relieving cough, reducing phlegm and relieving asthma. The method of relieving cough is usually the combination of dispersing and descending. Reducing phlegm usually takes the methods of warmly dissipation, assisted with clearing heat.②The treatments for stomach-ache usually are dispersing the depressed liver-qi to regulate stomach, invigorating spleen and nourish spleen, simultaneously protecting qi and yin. The characteristics of prestigious TCM doctors are treating both liver and stomach, separately treating spleen and stomach, focusing on regulating qi and dieting therapy.③The treatments for abdominal mass follow the rules of strengthening healthy qi to eliminate pathogens and treating both superficiality and origin. The prestigious TCM doctors mainly use the combination of promoting blood flow to dredge meridians and supplementing yin to nourish blood.④Prestigious TCM doctors treat stranguria from the dampness abundance due to spleen deficiency and damp-heat gluing and blood stasis due to qi stagnancy, and use clearing heat and eliminating dampness, dispersing depressed liver-qi to regulate qi, clearing blood stasis and removing urinary calculus.⑤In the treatment of cancer, the prestigious TCM doctors treat symptoms by conteracting toxic and eliminating stasis, treat origin by nourishing yin and body fluids.⑥The prestigious TCM doctors'basic treatments for Bi syndrome are dispelling wind and dampness, nourishing liver and kidneys, they also be skilled in using vines, arthropods to eliminate wind and dredge meridians.
Conclusions
The thesis is the first time to investigate and arrange the empirical prescriptions of prestigious TCM doctors who were titled by Guangdong and Guangzhou government. The thesis sorted out 884 empirical prescriptions of 88 prestigious TCM doctors and formed "The selected empirical prescriptions of prestigious TCM doctors in Guangzhou". Above is the first innovation Although the selected prescriptions did not reflect the prestigious TCM doctors'experience from every aspect, they did reflect the uniqueness of clinical practice of prestigious TCM doctors in Guangdong, such as effective differentiation between cold attack diseases and seasonal febrile disease, attention to the hot and humid climate in Lingnan region, using local herbal medicine for qi-yin-deficiency constitution of local people, medication rules of removing heat to cool blood and detoxicate, invigorating spleen to remove phlegm, supplementing qi and nourish yin to nourish kidneys, simultaneously treatment for liver-heart-lung, regulating qi and blood to dredge meridians, simultaneously application of purging-tonifying therapy. The empirical prescriptions make a indelible contribute to the health care of Guangzhou people.
The second innovation is commenting and statistically analysing the internal prescriptions on the basis of Five-zang syndromes differentiation. The results showed that prestigious TCM doctors in Guangzhou focus on Five-zang syndromes differentiation and have obvious characteristics of clinical diagnosis and treatment. The empirical prescriptions of prestigious TCM doctors have inheritability, regional characteristic, practicability, compatibility and innovation.
This research is a difficult work, pat of which is still unfinished. The follow-up deeper study aims at sorting empirical prescriptions of prestigious TCM doctors in Guangzhou from wilder scope on the basis of finished study. The future work will focus on analyzing the data by mathematics analysis tool, which aims at discovering the correlation between diseases and drugs, diseases and Zang-fu organs, and finding the generality and speciality among treatments. This work will provide a basis for the promotion and development of empirical prescriptions of prestigious TCM doctors and explore their economic benefits and social benefits.
引文
[1]邓铁涛.岭南医学.新中医,1999,31(8)：8～9.
[2]邓铁涛、靳士英.略谈岭南医学之特点[S].广东医史分会成立大会论文选编,中华医学会广东分会,1986：47
[3]徐愈颖,马艺华,施旭光等.岭南中医民间单方、验方收集整理研究[J].中药材,2009,32(1)：162～165
[4]广东省医药卫生研究所中医研究室.广州近代老中医医案医话选编[M].广州：广东科技出版社,1979,2
[5]陈镜合,陈沛坚等.当代名老中医临证荟萃[M].广州：广东科技出版社,1987,10
[6]宋祖敬等.当代名医证治荟萃[M].石家庄：河北科学技术出版社,1990,9
[8]董建华,杜怀棠.中国当代名医验方大全[M].石家庄：河北科学技术出版社出版,1991
[7]任继学.中国名老中医经验集萃[M].北京：北京科学技术出版社,1993,11
[9]张天启,李致重.杏林真传[M].北京：华夏出版社.1994,6
[10]张丰强,郑英等.首批国家级名老中医效验秘方精选[M].北京：国际文化出版社,1996,1
[11]耕耘,李蓉.国家级名老中医验方大全[M].伊犁人民出版社,1999,3
[12]钟仲贤.钟玉池学术思想及临床经验[J].新中医,1989,21(3)：8～11
[13]黄关亮.蔡荣副教授学术思想及治疗经验简介[J].新中医.1989,21(4)：8～11
[14]张横柳.岭南伤寒名家何志雄学术思想简介[J].新中医,1989,21(5)12～13,19
[15]林季文.名老中医文子源学术思想及治验简介[J].新中医.1992.24(5)：1～4
[16]黎汉津.沈炎南教授学术思想简介[J].新中医,1993,25(6)：2～3
[17]罗日永.钟耀奎教授治疗肝性胸水经验[J].新中医,2002,24(2)：2～3
[18]饶媛.邓铁涛临床诊疗特色[J].上海中医药杂志,2005,39(6)：57
[19]明顺培.司徒铃教授针灸经验总结[J].广州中医药大学学报,2006,23(5)：369～374
[20]邓铁涛.邓铁涛临床经验辑要[M].北京：中国医药科技出版社,1998,1
[21]广州中医药大学温病学教研室.刘仕昌学术经验集[M].广州：广东高等教育出版社,1996,12
[22]赖新生,张家维.岭南针灸经验集[M].中国医药科技出版社,1998,1
[23]何应华,李主江.何竹林正骨医粹[M].广州：广东科技出版社,2003,7
[24]卢集森.近代西关岭南名医[M].广州：广东科技出版社,2004,3
[25]黎世明.黎炳南儿科经验集[M].北京：人民卫生出版社,2004,4
[26]卢集森.岭南名家胡肇基医学精华[M].广州：广州出版社,2005,1
[27]罗颂平,张玉珍.罗元恺妇科经验集[M].上海：上海科技出版社,2005,3
[28]胡玲,黄志新.劳绍贤医学文选[M].广州：广东科技出版社,2005,4
[29]广州市中医院.广州市中医院名医临证精要[M].广州：广东人民出版社,2006,12
[30]李国准.西关正骨——李氏临证经验[M].广州：岭南美术出版社,2008,12
[31]邓小英,刘小斌.从医案探求岭南名老中医临床诊疗特点[J].四川中医,2008,26(7)：36～38
[32]刘小斌,陈忠烈,梁川.岭南中医药名家[M].广州：广东科技出版社,2010,2
[33]《广东省中药志》编辑委员会.广东省中药志[M].广州：广东科技出版社,1994,5
[34]南京中医药大学.中药大辞典[M].上海：上海科技出版社,2006,4
[35]释继洪.岭南卫生方·李侍制瘴疟论(影印本)[M].北京：中医古籍出版社,1983,1～2.
[36]王云飞,吴焕林.邓铁涛教授与岭南医学[J].新中医,2007,39(6)：92～93
[37]何梦瑶.医碥.见：邓铁涛主编.邓铁涛医学文集[M].北京：人民卫生出版社,2001,933.
[38]何梦瑶.医碥.见：邓铁涛主编.邓铁涛医学文集[M].北京：人民卫生出版社,2001,765.
[39]彭胜权,等.岭南温病研究[J].新中医1997,29(10)：2
[40]王伟彪,郑洪.岭南人体质特点与何梦瑶火热论[J].广东医学,1998,19(1)：68-69
[41]郭姣,赖远征.试论岭南外感热病的几个特点[J].中医药学报,1999,(1)：5～8
[42]刘小斌,杨权生.广东草药学医家医著简介[J].新中医,1987,(10)：52～53
[43]中华人民共和国卫生部药典委员会.中华人民共和国药典(1995年版)[M].广州：广东科技出版社,1996,8
[44]黄兆胜.全国高等医药教材建设研究会规划教材·中药学[M].北京：人民卫生出版社,2002,8
[45]郑洪.岭南医学自然、历史、与文化[C].见：广东省中医药学会岭南医学专业委员会.广东省中医药学会岭南医学专业委员会第一次学术年会论文集.广州：2000,12：22～27
[46]肖莹.试论岭南医学发展的文化特征[J].广州中医药大学学报,1998,15(3)：225～226
[2]邓铁涛、靳士英.略谈岭南医学之特点[S].广东医史分会成立大会论文选编,中华医学会广东分会,1986：47
[3]徐愈颖,马艺华,施旭光等.岭南中医民间单方、验方收集整理研究[J].中药材,2009,32(1)：162～165
[4]广东省医药卫生研究所中医研究室.广州近代老中医医案医话选编[M].广州：广东科技出版社,1979,2
[5]陈镜合,陈沛坚等.当代名老中医临证荟萃[M].广州：广东科技出版社,1987,10
[6]宋祖敬等.当代名医证治荟萃[M].石家庄：河北科学技术出版社,1990,9
[8]董建华,杜怀棠.中国当代名医验方大全[M].石家庄：河北科学技术出版社出版,1991
[7]任继学.中国名老中医经验集萃[M].北京：北京科学技术出版社,1993,11
[9]张天启,李致重.杏林真传[M].北京：华夏出版社.1994,6
[10]张丰强,郑英等.首批国家级名老中医效验秘方精选[M].北京：国际文化出版社,1996,1
[11]耕耘,李蓉.国家级名老中医验方大全[M].伊犁人民出版社,1999,3
[12]钟仲贤.钟玉池学术思想及临床经验[J].新中医,1989,21(3)：8～11
[13]黄关亮.蔡荣副教授学术思想及治疗经验简介[J].新中医.1989,21(4)：8～11
[14]张横柳.岭南伤寒名家何志雄学术思想简介[J].新中医,1989,21(5)12～13,19
[15]林季文.名老中医文子源学术思想及治验简介[J].新中医.1992.24(5)：1～4
[16]黎汉津.沈炎南教授学术思想简介[J].新中医,1993,25(6)：2～3
[17]罗日永.钟耀奎教授治疗肝性胸水经验[J].新中医,2002,24(2)：2～3
[18]饶媛.邓铁涛临床诊疗特色[J].上海中医药杂志,2005,39(6)：57
[19]明顺培.司徒铃教授针灸经验总结[J].广州中医药大学学报,2006,23(5)：369～374
[20]邓铁涛.邓铁涛临床经验辑要[M].北京：中国医药科技出版社,1998,1
[21]广州中医药大学温病学教研室.刘仕昌学术经验集[M].广州：广东高等教育出版社,1996,12
[22]赖新生,张家维.岭南针灸经验集[M].中国医药科技出版社,1998,1
[23]何应华,李主江.何竹林正骨医粹[M].广州：广东科技出版社,2003,7
[24]卢集森.近代西关岭南名医[M].广州：广东科技出版社,2004,3
[25]黎世明.黎炳南儿科经验集[M].北京：人民卫生出版社,2004,4
[26]卢集森.岭南名家胡肇基医学精华[M].广州：广州出版社,2005,1
[27]罗颂平,张玉珍.罗元恺妇科经验集[M].上海：上海科技出版社,2005,3
[28]胡玲,黄志新.劳绍贤医学文选[M].广州：广东科技出版社,2005,4
[29]广州市中医院.广州市中医院名医临证精要[M].广州：广东人民出版社,2006,12
[30]李国准.西关正骨——李氏临证经验[M].广州：岭南美术出版社,2008,12
[31]邓小英,刘小斌.从医案探求岭南名老中医临床诊疗特点[J].四川中医,2008,26(7)：36～38
[32]刘小斌,陈忠烈,梁川.岭南中医药名家[M].广州：广东科技出版社,2010,2
[33]《广东省中药志》编辑委员会.广东省中药志[M].广州：广东科技出版社,1994,5
[34]南京中医药大学.中药大辞典[M].上海：上海科技出版社,2006,4
[35]释继洪.岭南卫生方·李侍制瘴疟论(影印本)[M].北京：中医古籍出版社,1983,1～2.
[36]王云飞,吴焕林.邓铁涛教授与岭南医学[J].新中医,2007,39(6)：92～93
[37]何梦瑶.医碥.见：邓铁涛主编.邓铁涛医学文集[M].北京：人民卫生出版社,2001,933.
[38]何梦瑶.医碥.见：邓铁涛主编.邓铁涛医学文集[M].北京：人民卫生出版社,2001,765.
[39]彭胜权,等.岭南温病研究[J].新中医1997,29(10)：2
[40]王伟彪,郑洪.岭南人体质特点与何梦瑶火热论[J].广东医学,1998,19(1)：68-69
[41]郭姣,赖远征.试论岭南外感热病的几个特点[J].中医药学报,1999,(1)：5～8
[42]刘小斌,杨权生.广东草药学医家医著简介[J].新中医,1987,(10)：52～53
[43]中华人民共和国卫生部药典委员会.中华人民共和国药典(1995年版)[M].广州：广东科技出版社,1996,8
[44]黄兆胜.全国高等医药教材建设研究会规划教材·中药学[M].北京：人民卫生出版社,2002,8
[45]郑洪.岭南医学自然、历史、与文化[C].见：广东省中医药学会岭南医学专业委员会.广东省中医药学会岭南医学专业委员会第一次学术年会论文集.广州：2000,12：22～27
[46]肖莹.试论岭南医学发展的文化特征[J].广州中医药大学学报,1998,15(3)：225～226
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |