乳痈古今用药差异及原因分析  

Analysis of Drug Application Difference and Its Causes in Treating Acute Mastitis

作　　者：李明 丁艳亭[2] 苗鑫 张莉 张萌 张明 李湘奇 LI Ming;DING Yanting;MIAO Xin;ZHANG Li;ZHANG Meng;ZHANG Ming;LI Xiangqi(The Second Affiliated Hospital of Shandong First Medical University,Taian 271000,China;Taian Hospital of Traditional Chinese Medicine,Taian 271000,China)

机构地区：[1]山东第一医科大学第二附属医院,山东泰安271000 [2]泰安市中医医院,山东泰安271000

出　　处：《山东中医杂志》2020年第8期797-800,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划课题(编号:2017-256)。

摘　　要：通过查阅历代治疗乳痈的主要文献,整理相关的治疗方剂,分析其药物使用规律,比较古今异同。发现唐代以前医家认为本病之病机为营卫气血不和,因此多采用补益气血、温通经络的方法治疗,药多以人参、黄芪、肉桂、防风等为主;明清之后的医家认为本病多为“热毒侵袭”,因而其治法以清热解毒为主,药以瓜蒌、连翘、金银花、黄芩等清热解毒之品为主;乳痈的证治经历了由整体气血辨证向局部阴阳辨证的转化,由补益气血为主向清热解毒为主的治法变化,而分析促进其转变的原因当与金元时期医家火热病机的阐发密切相关。Through consulting the main literature of the treatment of acute mastitis in the past dynasties,sorting out the relevant treatment prescriptions,analyzing the regularity of drug application,and comparing the ancient and modern similarities and differences,it is found that before the Tang Dynasty,doctors thought that the pathogenesis of the disease was disharmony of qi and blood,so they mostly used the methods of tonifying qi and blood,warming meridians and collaterals.Most of the drugs were Renshen(ginseng),Huangqi(astragalus),Rougui(cinnamon)and Fangfeng(radix sileris).After the Ming and Qing Dynasties,doctors thought that the disease was mostly caused by“heat toxin invasion”,so their treatment mainly focused on clearing away heat and detoxifying,the medicine was mainly composed of Gualou(trichosanthes),Lianqiao(forsythia),Jinyinhua(honeysuckle),Huangqin(scutellaria)and other heat-clearing and detoxifying products.The treatment of acute mastitis had experienced the transformation from the syndrome differentiation of qi and blood as a whole to the syndrome differentiation of yin and yang as a part,from the treatment of invigorating qi and blood to the treatment of heat clearing and detoxifying as a main part,and the reasons for promoting the transformation should be closely related to the elucidation of the pathogenesis of heat and fire of doctors in the Jin and Yuan period.

关 键 词：乳痈 补益气血 清热解毒 寒凉药 温热药 火热病机 历史演变 

分 类 号：R271.44[医药卫生—中医妇科学]