赵泉霖基于“清”“消”“补”三法治疗甲状腺结节用药规律探析  

Analysis on ZHAO Quanlin’s Medication Regularity in Treatment of Thyroid Nodules by Three Methods of“Clearing”“Resolving”and“Tonifying”

作　　者：董又滋 路中艳 侯广建 赵泉霖(指导) DONG Youzi;LU Zhongyan;HOU Guangjian;ZHAO Quanlin(The Second Affilicated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China;不详)

机构地区：[1]山东中医药大学第二附属医院,山东济南250001 [2]山东中医药大学,山东济南250355 [3]不详

出　　处：《山东中医杂志》2023年第11期1160-1166,共7页Shandong Journal of Traditional Chinese Medicine

摘　　要：目的:探析赵泉霖教授治疗甲状腺结节的组方用药规律,总结其相关诊疗经验。方法:选取赵泉霖教授治疗的甲状腺结节患者102例,收集患者病历中的处方,对处方药物进行归纳整理。运用Excel软件建立数据库,对药物的功效、性味、归经等进行频数分析;运用SPSS 19.0软件进行R型聚类及关联规则分析,寻找基本药对及高频药物组合。结果:共纳入45首方剂,包含105味中药。清热药、补虚药、解表药应用频次最高,代表药物有夏枯草、连翘、甘草、白芍、柴胡等;药物性味以苦、甘、寒为主,多归肝、肺、心经。高频药对包括柴胡-白芍、柴胡-夏枯草、夏枯草-浙贝母等,高频药物配伍组合包括僵蚕-浙贝母-夏枯草、连翘-僵蚕-浙贝母、夏枯草-浙贝母-连翘等。结论:赵泉霖教授认为甲状腺结节的发生与情志密切相关,其病为肝所主,临证擅长运用《医学心悟》治疗八法中的“清”“消”“补”三法,即采用清郁热、散瘿结、补阴液的方法,并结合五行生克制化规律,在清肝的同时配伍清心、肃肺之品,临床多获良效。Objective:To analyze the medication regularity of Professor ZHAO Quanlin in treatment of thyroid nodules(TN),and summarize his experience in diagnosis and treatment of this disease.Methods:The medical records of 102 patients with TN treated by Professor ZHAO Quanlin were collected,and the Chinese medicinals in the medical records were summarized and analyzed.A database built by Excel software was used for analyzing the frequency of the medicinal’s effects,properties,tastes and meridian tropism.The SPSS 19.0 software was used for R clustering analysis and association rule analysis,so as to find out the basic medicinal pairs and the medicinal combinations with high frequency.Results:A total of 45 presc-riptions with 105 Chinese medicinals were included,among which heat-clearing medicinals,tonifying medicinals and exterior-releasing medicinals were used most frequently,including Xiakucao(Prunellae Spica),Lianqiao(Forsythiae Fructus),Gancao(Glycyrrhizae Radix et Rhizoma),Baishao(Paeoniae Radix Alba),Chaihu(Bupleuri)and so on.The properties and tastes of the medicinals were mainly bitter,sweet and cold,and most medicinals entered the liver,lung and heart meridian tropism.The high-frequency medicinal pairs included Chaihu-Baishao,Chaihu-Xiakucao,Xiakucao-Zhebeimu(Fritillariae Thunbergii Bulbus)and so on.The high-frequency medicinal combinations included Jiangcan-Zhebeimu-Xiakucao,Lianqiao-Jiangcan-Zhebeimu,Xiakucao-Zhebeimu-Lianqiao and so on.Conclusions:Professor ZHAO Quanlin believes the occurrence of TN is closely related to emotion,and the disease is mainly caused by disorder of the liver function.In treatment of TN,Professor ZHAO Quanlin uses three methods of“clearing”,“resolving”and“tonifying”among the eight treatment methods proposed by Medical Insight.Concretely speaking,the three methods are clearing stagnant heat,resolving goiter and mass,and tonifying yin fluid.Besides,according to the generating and restraint regularity of the five elements,medicinals for clearing the heart and purifying the l

关 键 词：甲状腺结节 情志 用药规律 清郁热 散瘿结 补阴液 赵泉霖 

分 类 号：R259.81[医药卫生—中西医结合]