基于现代医案探讨小青龙汤的证治特点-方剂学专业论文.docxVIP

PAGE PAGE 4 中文摘要 目的：对小青龙汤的适应病种、病机、症状、舌脉、原方药物、加味药物及 用药剂量、证-症-药的关系等进行统计和探讨。 方法：从核心期刊及诸多优秀出版社出版的医案书籍中选取符合标准的 204 例医案，对医案中的症状、病机等内容进行统一规范后，用 Excel 建立数据表， 采用归类统计的方法，总结小青龙汤在病种、病机、症状、舌脉、证-症-药等方 面的特点。 结果：小青龙汤的临床应用，频次较高的中医病名前三位依次为咳嗽、哮病、 喘证；西医病名依次为支气管哮喘、急慢性支气管炎、肺气肿。病机频次较高的 一为复合病机：风寒袭表、寒饮停肺；一为单一病机：寒饮停肺。症状出现频率 高于 30%的依次为：咳嗽、胸闷、气喘、痰白稀、食欲不振、痰量多，舌脉以舌 淡苔白腻，脉浮紧或弦滑最为多见。原方药物出现频次居前五位依次为：半夏、 细辛、干姜、桂枝、五味子，加味药物最常加茯苓、杏仁、苏子。原方药物 193 例成人平均量为：半夏 10.37g、细辛 4.7g、干姜 8.95g、桂枝 9.44g、五味子 7.23g、炙甘草 8.47g、麻黄 8.22g、白芍 11.05g；小儿剂量为半夏 6.89g、细辛 2.69g、干姜 5.06g、桂枝 5.13g、五味子 5.25g、炙甘草 3.94g、麻黄 6.00g、 白芍 5.86g。临床应用小青龙汤最多的三个病种咳嗽、喘证、哮病，在加味药物 的使用上无明显差异，均常加茯苓、杏仁，说明中医的特色正是“辨证论治”为 主，而不是“辨病论治”为主，病不同，证相通，治法处方亦相近。 结论：小青龙汤在适应病种、病机、症状、舌脉、加味药物、证-症-药等方 面有其一定的特点，临床仍以辨证论治为主。 关键词 小青龙汤 方证特点 频次统计 Abstract Objective: To statistically analyze and explore Xiao Qing Long Tang’s applicable diseases, pathogenesis, symptoms, tongue and pulse conditions, as well as its original formula ingredients, added medicinals, dosage and the relations among the patterns, symptoms and medicinals. Methods: 204 medical cases in accordance with the standard were selected from core journals and many books of medical cases published by significant presses. Excel data tables were established after contents like symptoms and pathogenesis in the medical cases were standardized. Classified statistics method was applied to sum up the characteristics of Xiao Qing Long Tang’s applicable diseases, pathogenesis, symptoms, tongue and pulse conditions, and the relations among the patterns, symptoms and medicinals, and so on. Results: In clinical application of the Xiao Qing Long Tang, the first three diseases with the highest frequency in TCM are orderly the cough, wheezing and dyspnea; in Western medicine are orderly the bronchial asthma, acute and chronic bronchitis and emphysema. The pathogenesis with relatively high frequency is compound pathogenesis (wind-cold attacking the exterior and cold fluid retention lingering in the lung) on one hand and