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目的通过对比汉、唐、宋、明、清、当代医家临证保胎用药规律的相同与异同点,分析各朝代医家临证处方用药特色。方法选择汉代至当代医家临证保胎医案为研究对象,运用传统文献学与方剂计量学方法,对各朝代医家临证处方常用药物四性、五味、归经、功效运用情况进行方剂计量学特有指标的对比分析。结果各朝代医家临证保胎用药温热/寒凉比值皆大于1。五味频次比较中,只有明代偏重于酸甘,其他各朝代都偏重于辛甘。除当代用药以后天与先天并补而更偏重补肝肾外,其他朝代脾胃/肝肾均小于1,以补后天脾胃为重。补益药使用频次以当代为最(4.60),明代(4.57),清代(3.05),宋代(2.30),唐代(1.86)。各朝代医家临证处方高频用药宜聚为3类:唐代和宋代聚为一类,同时与汉代聚为一大类;清代和当代聚为一类;明代单独为一类。结论各朝代医家保胎用药多以补虚为主,兼有活血、止血、清热、解表等方法。各医家在继承前人思想的基础上结合所处历史时期的疾病特色能够辨证用药,各有特色。用药都偏温热,佐以辛甘,攻补兼施,不忘先后天并补,用药逐渐丰富,辨证更趋完备。
Objective By comparing the similarities and differences between the medical regulations of Han, Tang, Song, Ming, Qing and contemporary physicians on the use of clinical prescriptions, the author analyzed the characteristics of medical prescriptions prescribed by doctors in each dynasty. Methods The medical records of Han and modern physicians were collected as the research object. By using the methods of traditional philology and prescription metrology, prescriptions were used to measure the effects of four medicinal herbs, five flavors, Comparative Analysis of Unique Indexes. Results of each dynasty doctor card miscarriage medication warm / cold ratio are greater than 1. Five flavors frequency comparison, only the Ming emphasis on sweet and sour, the other dynasties are all focused on Xin Gan. In addition to the day after the contemporary medication and innate complement and more emphasis on liver and kidney, the other dynastic spleen / liver and kidney are less than 1, to make up for the day after tomorrow spleen and stomach. The most commonly used tonic medicines were contemporary (4.60), Ming (4.57), Qing (3.05), Song (2.30) and Tang (1.86). Each dynasty doctor’s card prescription high-frequency medication should be grouped into three categories: the Tang Dynasty and the Song Dynasty together as a category, while the Han Dynasty together as a major category; the Qing Dynasty and the contemporary clustered into one category; the Ming Dynasty as a separate category. Conclusion The doctors of the dynasties use more tocolytic drugs for tocolysis, and both have methods of activating blood circulation, stopping bleeding, clearing heat and relieving symptoms. Based on their predecessors’ thoughts, all physicians can use the characteristics of the disease in their historical periods to differentiate their use of medicine. Medication are partial warm, accompanied by Xin Gan, attack and cure, did not forget the day and make up, medication gradually enriched, dialectics more complete.