论万全《幼科发挥》对小儿急惊风的认识与用药规律分析  

Understanding and Medication Rule of Acute Infantile Convulsion in WAN Quan's Elaboration on Pediatrics

作　　者：杨瑾 YANG Jin(Hubei University of Chinese Medicine,Wuhan430065,China)

机构地区：[1]湖北中医药大学,湖北武汉430065

出　　处：《基层中医药》2024年第4期67-72,共6页Basic Traditional Chinese Medicine

摘　　要：目的梳理万全在《幼科发挥》中对小儿急惊风的认识,统计分析其治疗小儿急惊风的方剂及药物,归纳其治疗小儿急惊风的学术思想。方法阅读万全《幼科发挥》,整理关于小儿急惊风的相关内容,筛选其治疗小儿急惊风的方剂,运用古今医案云平台进行统计分析,得出方剂中药物的四气、五味、归经、出现频次等,分析其用药规律,归纳总结小儿急惊风的病因病机及其分证论治,初步探析万全关于小儿急惊风的学术思想。结果29首相关方剂中,使用频次最高的药物依次是朱砂、黄连、人参等;出现了3个核心组合与7个置信度0.5以上的药对;以五味分析,苦味药出现84次,占比最多;四气分析中,寒性药物出现75次,占比最多;所有中药中,归经最多的为心经,其次为脾经。结论万全治疗小儿急惊风时,具有“重视清泻,尤重清心火”、“喜用温甘,顾护脾胃”的用药特点。他首次以三因理论论述了小儿急惊风的病因,认为主要病机是热则生风,并以病因为序,详细论述了“急惊风证”的审因论治,其治疗次第有序、内外并用,重视预防与善后。Objective To sort out WAN Quan's understanding of acute infantile convulsion(AIC)in Elaboration on Pediatrics,statistically analyze his formulas and medicinals for the treatment of AIC,and summarize his academic thoughts on the treatment of AIC.Methods Through reading WAN Quan's Elaboration on Pediatrics,the author sorted out the relevant content about AIC and screened formulas for the treatment.The Ancient and Modern Case Record Cloud Platform was used for statistical analysis to obtain four qi,five flavors,meridian affinity and occurrence frequency of medicinals in the screened formulas.The rules of medication were analyzed,the etiological factors,pathogenesis and treatment according to pattern differentiation of AIC were summarized,and WAN Quan's academic thought on AIC was preliminarily explored.Results Among the 29 relevant formulas,the most frequently used Chinese medicines were cinnabar,goldthread and ginseng.There were 3 core combinations and 7 couplet medicines with a confidence coefficient of more than 0.5.In the analysis of five flavors,bitter flour medicines appeared 84 times,accounting for the largest proportion.In the analysis of four qi,cold medicines appeared 75 times,accounting for the largest proportion.Among all the Chinese medicines,the heart meridian was the most common meridian affinity,followed by the spleen meridian.Conclusions In the treatment of AIC,WAN Quan paid attention to clearing and discharging,especially clearing heart fire,and preferred to use sweet-warm medicinals while taking care of the spleen and stomach.He first discussed the etiological factors of AIC with the theory of three types of disease causes,believing that the main pathogenesis was that heat produces wind.In the order of the cause of the disease,he discussed in detail the examination of the cause and treatment of AIC syndromes;his treatment method was orderly,paying attention to internal-external treatment as well as the prevention and prognosis.

关 键 词：小儿急惊风 万全 《幼科发挥》 用药规律 

分 类 号：R72[医药卫生—儿科]