宋元时期和现代文献脂肪肝相关病证的方药对比的研究.doc

摘　　　要　 宋元时期与现代文献脂肪肝相关病证的方药对比研究  硕士研究生：王转国 摘  导师：曾斌芳 要  主任医师  目的：以脂肪肝现代共识病名追溯宋元文献中相关方药理论的研究。寻找其用 药规律，为脂肪肝的中医药治疗提供借鉴，并丰富脂肪肝的中医治疗思路。方法： 以现代医家共识的脂肪肝中医病名为依据，通过对宋元主要医籍中防治脂肪肝相关 疾病的方药进行整理、并对其药物进行统计、分析。结果：研究表明宋元医家在“肝 痞”的治疗中以补泄兼顾，标本兼治；从脾论治，助化蠲浊；辛开苦降，甘温并施 为主。现代医家对脂肪性肝病的中医名称趋同于胁痛、积聚；中医证型按病理因素 分类，痰湿、肝郁、气滞、瘀血、脾虚、湿热为最主要因素；病证按所涉脏腑分类， 以肝脾肾三脏为主；证型按虚实分类，虚实夹杂型最常见；最常用药物依次为丹参、 泽泻、柴胡、山楂、首乌、茵陈、郁金、白术、决明子。结论：“胁痛”从虚论治、 坚守即病防变的思想、以温补为主，不忘理气活血，为历代医家所共识，现代医家 在此基础上健脾补肾疏肝，临床用药以肝脾肾经药物为主。又以消散之法为主，所 用药物性味均比较平和，少用大寒大热之品，具有标本兼顾的特色。 关键词：脂肪肝；文献；方药理论 1 新疆医科大学医学硕士学位论文　 The research on the explaination of adiposis hepatica prescription in documents from Song, Yuan and modern dynasties Postgraduate Wang Zhuan GuoSupervisor professor Zeng Bing Fang Abstract Objective: To research on the explaination of adiposis hepaticaprescription in documents from Song, Yuan dynasties with consensus modern disease names. Methods: Based on the consensus modern disease names, we categorized and statistical analyzed the prescriptions on hepatica treatment in Song, Yuan dynasties. Results: our research showed that the doctors from Song, Yuan dynasties treated Liver Swelling from three aspects: to give consideration to reinforcment of leaking and treatment of symptom and etiopathogenisis, to treat from the spleen and eliminate the turbidity, The modern TCM literature review on FLD shows that the modern medicine universally holds the names for FLD as Xie Tong (pains in flank), Ji Ju (accumulation), the most commonly witnessed type are liver depression and Qi stagnation, liver depression and liver deficiency, phlegm stasis and meridian obstructing, Qi-stagnancy and blood stasis. According to TCM classification of pathological factors, phlegmatic hygrosis, liver depression, Qi stagnation, blood stasis, liver deficiency, humid heat are the most important factors. According to the organs classification, the liver, spleen and kidney are most related. According to the classification of asthenia and sthenia, the most common actual