【作者】 吴蓉茹；

【导师】 罗颂平；

【作者基本信息】 广州中医药大学 ， 中医妇科学， 2011， 博士

【摘要】 目的中医药治疗闭经历史悠久,经验丰富且优势明显,但对闭经的病因病机和辨证论治方面存在着“仁者见仁,智者见智”的现象。本课题在大量收集秦汉至近现代关于闭经相关文献的基础上,以方剂和药物作为研究切入点,进行数据分析。探寻古代医家治疗闭经的用药规律,以便从整体上把握中医药治疗闭经的基本思路,以利于治疗方案的建立。方法本研究采用传统文献和数理统计相结合的方法,建立中医药治疗闭经数据库,进行频数分析。对治疗闭经方剂及药物的性味归经进行分析,整理研究了历代医家遣方用药的总体特点。结果1.建立了闭经方药数据库,即治疗闭经的前15味高频药物依次是：当归、芍药、川芎、桂枝、大黄、桃仁、甘草、丹皮、牛膝、红花、香附、熟地、延胡索、茯苓、白术。2.总结出治疗闭经的规律：闭经治疗在于调、补、通、缓,即调经之要在于调肝肾,补之基础在于固护脾胃,通经之用妙在变通,缓缓治疗以求痊愈。结论1.运用中医文献学“辨章学术,考镜源流”的研究方法,在搜集历代文献的基础上,系统整理了历代医家对闭经研究的相关文献并深入分析历代医家对闭经的认识。2.总结出治疗闭经的规律。提出闭经治疗在于调、补、通、缓,即调经之要在于调肝肾,补之基础在于固护脾胃,通经之用妙在变通,缓缓治疗以求痊愈。3.总结出闭经的常见虚证有：肾气不足证,肝肾虚损证,阴虚血燥证,气血虚弱证；实证有：血瘀气滞证,痰湿、脂膜壅塞证。虚证可用山茱萸、女贞子滋补肾水,白芍养血柔肝,仙茅、巴戟天温肾壮阳,白术、山药、阿胶益脾养血,当归、熟地养血活血；实证可用香附、月季、延胡索疏肝理气止痛,川芎理气活血,牛膝、红花、桃仁、大黄、芒硝、巴豆活血逐瘀通经,茯苓、苍术化湿消痰。更多还原

【Abstract】 ObjectiveChinese Medicine treatment of amenorrhoea has a long history. It has rich experience and distinct advantages, but physicians have different opinions about the pathogenesis, etiology, differentiation and treatment of amenorrhoea. On the basis of collecting amenorrhoea-related literature from Qin and Han Dynasty to modern age, the author takes prescription and medication as the breakthrough point, analyzes the data, and explores the medication rules of ancient physicians in amenorrhoea treatment so as to holistically grasp its basic thought ways of TCM therapy and establish the treatment plan.MethodsThis study adopts the traditional literature research and statistical methods and establishes the database about Chinese Medicine treatment for amenorrhea and conducts the pykno-analysis.ResultsEstablish the database of prescriptions and medicine for amenorrhea, analyze their nature, flavor and meridian distribution, sort out the general features of prescriptions and medicine by physicians of different generations and generalize the rules for amenorrhea treatment.Conclusion1. Adopt the TCM literature research method of tracing the origin, systematically sort out the related literature about physicians of different generations’ research on amenorrhea and conduct in-depth analysis, on the basis of collecting literature of different dynasties.2. Establish the database of prescriptions and medicine for amenorrhea, analyze the nature and flavor and meridian distribution, and sort out the general features of prescriptions and medicine by physicians of different generations. The top 15 high-frequency medicine for amenorrhoea treatment are: angelica, paeonia, rhizome ligustici, ramulus cinnamomi, rhubarb, peach seed, liquorice, cortex moutan, radix achyranthis, safflower, nutgrass galingale rhizome, prepared rhizome of rehmannia, corydalis, hoelen and atractylodes macrocephala.3. Summarize the rules for amenorrhoea treatment. It is proposed that its treatment should pay attention to toning, reinforcing, promotion and slowing down which means the key of toning the meridians is to tone the liver and kidney, the foundation of reinforcement is to reinforce the spleen and stomach, the merit of meridian promotion is to be flexible and the slow-down treatment is for full recovery.更多还原