《临证指南医案》中治疗郁证方药的用药规律和特色分析  

Analysis on Rules and Characteristics of Prescriptions for Depression Syndrome in Linzheng Zhinan Yi’an

作　　者：李峰[1] 来杰锋 傅燕燕[1] 倪伟 施维群 LI Feng;LAI Jiefeng;FU Yanyan;NlWei;SHI Weiqun

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]杭州师范大学附属医院,浙江杭州310011 [3]施维群名中医工作室,浙江杭州310011 [4]浙江中医药大学附属第二医院,浙江杭州310011

出　　处：《新中医》2019年第12期62-64,共3页New Chinese Medicine

基　　金：浙江省名老中医专家传承工作室建设计划项目（GZS2017008）

摘　　要：目的:用统计学方法对叶天士《临证指南医案》中治疗郁证的方药进行研究,分析、归纳叶天士治疗郁证的用药特色,为临床治疗郁证提供更有价值的处方思路。方法:选取《临证指南医案》郁证篇的医案处方,进行药物标准化,对其药物的频次、功效、气味归经、配伍等特征进行统计分析。结果:《临证指南医案》郁证篇复方共43首,总用药频次309次,用药91种;药性以寒、温为主;五味以甘味和苦辛味为多;归经以心、肝、脾经为多;按功效划分,使用频率较高的前四位依次为补虚药25.24%,清热药16.83%,化痰止咳平喘药11.33%,理气药8.41%;高频常用药对有远志-茯神、薄荷-茯苓、陈皮-茯苓、钩藤-陈皮等。结论:叶天士治疗郁证用药特色寒温并用,重用甘味药补益和中、缓急止痛,苦辛味药同用,辛开苦降宣通三焦脏腑气机,善用补虚药,调补气血,强调心、肝、脾的调摄,心神得养,肝气得疏,气机通畅则郁证自愈。Objective:To study and analyze the prescriptions for depression syndrome in Linzheng Zhinan Yi’an by Ye Tianshi via statistical methods,conclude the medication characteristics of Ye Tianshi treating depression syndrome,and provide more valuable thoughts on prescriptions for depression syndrome in clinical treatment.Methods:Selected the prescriptions in medical records from the Chapter of Depression Syndrome in Linzheng Zhinan Yi’an.Standardized the medicine,and statistically analyzed such features as frequency,efficacy,property-taste meridian tropism and compatibility.Results:In the Chapter of Depression Syndrome in Linzheng Zhinan Yi’an,there were totally 43 pieces of compound prescriptions,309 times in medication frequency and 91 types of medication;the properties of medicine mainly were cold and warm;sweet taste and bitter-acrid taste were majorly found in five tastes;the heart,liver and spleen meridians took the comparatively larger portion in meridian tropism;according to efficacy,"the top four medicines with the highest frequency of use were deficiency-tonifying medicine(25.24%),heat-clearing medicine(16.83%),phlegm-dispelling,cough-stopping and asthma-relieving medicine(11.33%)and qi-regulating medicine(8.41%)in sequence;the medicine pairs with high frequency were Polygala.Tenuifolia-Poria cum Radix Pini,Mentha piperita-Poria cocos(Schw.),Uncaria macrophylla-tangerine peel.Conclusion:The medication characteristics of Ye Tianshi treating depression syndrome are using both cold and warm efficacies,emphasizing the application of medicines with both sweet and bitter-acrid tastes,between which sweet-taste medicine reinforces and balances qi and relieves spasm and pain,and bitter-acrid taste medicine smoothes vital qi in three energizers through its acird-opening and bitter-downbearing functions,skillfully adopting deficiency-tonifying medicine for regulating and nourishing qi and blood,stressing the regulation of heart,liver and spleen,and believing that the self-recovery of depression will occur due to t

关 键 词：《临证指南医案》 郁证 用药规律 用药特色 

分 类 号：R277.7[医药卫生—中医学]