从气机升降出入论“魄门亦为五脏使”拓展小儿便秘治疗新思维-中医儿科学专业论文.docxVIP

中文摘要 目的： 从人体气机升降出入之运行模式，论述《内经》“魄门亦为五脏使”的临床意 义，旨在阐明五脏六腑气机之升降出入对调控、影响和启闭魄门的临床思维，从 而拓展小儿便秘治疗新路径。 方法： 总结古代医家对于五脏气机升降与魄门的关系，参考现代文献研究，结合导师临 床经验，认识到小儿便秘的治疗实从气机升降入手通过“魄门亦为五脏使”的理论， 运用加减小柴胡汤调整气机升降，开启魄门，打破传统的以“下法”、“润法”为主治 疗小儿便秘的方法，从而拓展了小儿便秘治疗的新思维。特收集导师门诊病例 60 例， 治疗组和阳性对照组分别予以相应剂量的加减小柴胡汤煎液及四磨汤口服液口服治 疗。连续给药 2 周后，进行治疗组前后与对照组治疗后在疾病疗效和证候疗效的比较。 结果： 在主症各项，治疗组和对照组治疗后组间比较有统计学意义(P0.05)；在次症各项， 治疗组和对照组治疗后组间及组内比较有统计学意义(P 0.05)。疾病疗效：治疗组总有 效率 90.0%，对照组总有效率 73.3％，两组比较有统计学意义（P0.05）。证候疗效： 治疗组总有效率 93.3％，对照组总有效率 63.3％，两组比较有统计学意义(P 0.05)。 结论： 从气机升降入手通过“魄门亦为五脏使”的理论，运用加减小柴胡汤治疗气机郁滞 型小儿便秘疾病疗效及证候疗效肯定，其疾病疗效及证候疗效均优于对照组。 关键词：气机升降 魄门 小儿便秘 小柴胡汤 气机郁滞型 [Objective]: Abstract From running mode of human body ’s ascending-descending and coming in-going out, we discuss clinical meaning of ‘anus can be used by five viscera as well’, in order to illuminate clinical thinking that ascending-descending and coming in-going out can control 、 affect 、 open and close anus. Accordingly we can expand new pathway of curing children constipation. [Methods]: This text realizes that treatment of children constipation begins with activities of qi hoisting through theory of anus can be used by five viscera as well, apply additional Bupleurum tenue Buch.-Ham Decoction to adjust activities of qi hoisting, to open anus, surmount traditional method of decantaing regulation mainly, accordingly expand latest thoughts. And this theory can be arrived by summarizing ancient times doctors’ relation of activities of qi hoisting and anus, referencing investigation of contemporary literature, binding clinical experience of advisor. So collecting sixty in OPD case, treatment group was treated with additional and diminished Bupleurum tenue Buch.-Ham Decoction , and the comparison group with Decoction of Four-Drug Juice, with the dosage of both group decided according to age. Successive medication of four weekes later, two kinds of comparisons were made on curative effect of the disease as well as syndrome, one was between the two group and the