吕绍光治疗不同肝郁程度围绝经期非器质性失眠的用药特点  

Prescription Rules of Treating Liver Depression in Perimenopausal Women with Non-organic Insomnia from LYU Shao-guang

作　　者：陈莹[1] 李红[1] 谢丽君 陈婷 马坤[1] 郑姜钦[1] 陈翔[1] 吕绍光[1] CHEN Ying;LI Hong;XIE Li-jun;CHEN Ting;MA Kun;ZHENG Jiang-qin;CHEN Xiang;LYU Shao-guang(Fujian Provincial Clinical Medical College,Fujian Medical University,Fuzhou Fujian 350001,China;Zhangzhou Hospital of Traditional Chinese Medicine,Zhangzhou Fujian 363000,China)

机构地区：[1]福建医科大学省立临床医学院,福建福州350001 [2]漳州市中医院,福建漳州363000

出　　处：《中医药导报》2020年第2期91-93,共3页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：福建省卫生计生青年科研课题(2016/1/6);福建省医学创新课题(2016-CX-8);福建省中医药科研项目计划(2017FJZYLC103);国家中医药管理局第四批全国中医(临床、基础)优秀人才研修项目[国中医药人教发[2017]24号]。

摘　　要：目的:分析吕绍光治疗不同肝郁程度围绝经期非器质性失眠的用药特点,传承其临床思路及经验。方法:收集219例经吕绍光诊治的肝郁型围绝经期非器质性失眠患者的处方。参照证素辨证标准,分为肝郁2级105例,肝郁3级114例,进一步对医案处方进行分析。结果:肝郁2级用药以"苦寒"为主,肝郁3级用药以"甘(平)温"为主,差异有统计学意义(P<0.01);除归肝经外,肝郁2级用药多归心肺经,肝郁3级用药多归脾肾经,差异有统计学意义(P<0.01);肝郁2级用药以理气药、安神药、清热药居多,肝郁3级以补虚药、安神药、活血药居多,差异有统计学意义(P<0.01)。结论:吕绍光认为肝郁型围绝经期非器质性失眠肝郁2级以实证为主,肝郁3级多夹虚,在疏肝理气安神的基础上,肝郁2级多兼予清热,肝郁3级多兼予补血、化瘀。Objective: To sum up the prescription rules in treating perimenopausal non-organic insomnia and different level of liver depression from LYU Shao-guang. Methods: The 219 prescriptions of liver depression type perimenopausal non-organic insomnia patients diagnosed and treated by LYU Shao-guang were collected.According to the syndrome differentiation standard, there are 105 cases of liver depression of grade 2 and 114 cases of liver depression of grade 3. The prescription of medical cases is further analyzed. Results: Bitter-Cold herbs were commonly used in the level 2 of liver depression, Sweet-Warm herbs were commonly used in the level 3, the difference is statistically significant(P <0.01). The mainly meridian distribution in level 2 of liver depression was liver, also meridian distribution of heart and lung;while the mainly meridian distribution in level3 was liver, also meridian distribution of spleen and kidney, the difference is statistically significant(P <0.01).The main drugs used in the level 2 of liver depression were Qi regulating drugs, tranquilizing drugs and heat clearing drugs, the main drugs used in the level 3 of liver depression were tonic drugs, tranquilizing drugs and blood activating drugs, the difference was statistically significant(P<0.01). Conclusion: Professor LYU treats liver depression in perimenopausal non-organic insomnia based with soothing liver and tranquilizing mind, he think that the level 2 of liver depression is mainly excess syndrome which treatment is based on clearing heat. The level 3 of liver depression is mainly deficiency syndrome that the treatment is based on blood enriching and removing blood stasis.

关 键 词：肝郁 围绝经期 失眠 非器质性 用药规律 吕绍光 

分 类 号：R256.26[医药卫生—中医内科学]