【作者】 张维文；

【导师】 刘持年；

【作者基本信息】 北京中医药大学 ， 中医方剂学， 2005， 博士

【摘要】 处方方法是方剂学研究的重要内容之一。方是法的体现,通过对大样本功用近似的处方进行用药统计分析,从中可归纳出某类方剂的处方方法。血虚证是临床常见证候,见于多种疾病过程之中,因此深入研究补血法的处方规律,为指导临床灵活运用补血古方,并创制补血新方提供依据。本文在导师指导下,采用“辩章学术,考镜源流”的文献研究方法,收集整理历代有关补血处方,对其用药进行统计分析,从而归纳出补血法的处方规律。论文分四部分进行论述: 第一部分:中医处方学的历史与发展。中医处方学有着悠久的历史。处方法是宋代医家许洪在《指南总论》中提出的,张景岳在《景岳全书》中称之为八略;程钟龄在《医学心悟》中提出医门八法。1949 年以后,随着中医药事业的复兴和发展,对方剂理论有了进一步的研究和总结,为处方学的发展奠定了基础。北京李庆业教授编著的《中医处方方法学》对处方法进行了系统论述,为处方学的发展作出了重要贡献。 第二部分:“方从法出,以法立方”。首先对方与法的关系进行了探讨,法是由方演化而来,在历史上先有方后有法,方是历代医家针对病证而创制的。而法是从一定数量的处方中总结提炼出来的处方规律,从方到法是运用中药治病的一次质的飞跃和理论上的升华。方剂和处方法关系甚为密切,主要表现在依法立方,依法用方、依法释方等方面。继而明确处方法的概念,并对处方法与治法、立法进行了辨识。此外,亦对处方的组成原则、组成结构、组成变化进行了探讨。 第三部分:补血法的概念与处方规律。补血法是以补血药为主组成处方,用以治疗血虚证的处方方法。补血法的主治病证为血虚证,本文对血虚证的古今研究概况进行梳理,使对血虚证的纵向发展有了一定程度的理解。这在借鉴古人经验的基础上,结合现代医学知识,为临证治疗血虚证,制定出全面有效的治疗方案提供指导。另外对血虚证进行横向研究,探讨其病因病机、临床表现,及其与类似证的鉴别,分清主证、次证,及主症、次症,为补血法选药组方提供依据。通过以上对处方法与血虚证的研究,进而对补血法的处方规律进行探讨。补血法处方针对血虚这一主证选用补血药为主药,但在大失血等危急情况下亦可以益气药为主药,而起到益气生血及固脱止血之效。补血药物在方中亦可作为辅药或佐药,与主药配伍有相须之义。补血处方除以补血药物为辅外,亦常选用益气药、滋阴药、温阳药、活血药、填精药、安神药等为方中辅药,分别依据气能生血、津血同源、阳中求阴、祛瘀生新、精血互生、血能养神的理论而设。根据血虚兼夹次证的不同,可选理气药、解表药、清热解毒药、熄风药、利水渗湿药、化痰药等作为方中佐药,以治疗相应次证。选用甘草调和诸药,缓和药性为补血处方中的使药。 第四部分:资料的收集与整理。学生查阅大量有关文献,收集补血药物及补血处方,并对其加以整理。将所收集的 1188 首补血处方用 Microsoft Office Professional XP—Access 2003 建立数据库,再从中选取 205 首对其配伍进行分析,更多还原

【Abstract】 The means of prescription is one of the most important contents in the studying of formulas of TCM. It is said that formulas embody principles, so we can deduce the means of prescription from some kind of formulas by drugs statistic analyzing based on massive samples of similar functional formulas. Seeing that blood deficiency is a common syndrome of many diseases, we could wield the principles of nourishing blood to guide clinical doctors wielding antiquity formulas and creating new formulas, under the guidance of my tutor, this thesis discusses the origin and development and conceptions of associated prescriptions, trying to deduce the principles of nourishing blood formulas. The article contains four parts: Part one is the origin and development of prescription of TCM. Prescription of TCM has a long-standing history. XuHong, who was a Song Dynasty doctor, put forward the means for prescriptions in general introduction guidebook, which led to an epoch-making significance for the establishing of prescription means. Then in Ming Dynasty, ZhangJingYue raised eight strategies, eight kinds of prescription means. Chengzhongling summarized all the prescription means and named them eight principles in Qing Dynasty. After 1949, the prescription theories of TCM went step further with the reviving and developing of TCM , which settles a substantial foundation to the development of formulas of TCM. prescriptions of TCM, compiled by LiQingye of Beijing, discussed the prescription means systematically, made an important contribution to the development of formulas of TCM. Part two is of the relationship of formulas and principles. Formulas of TCM, emerged earlier than prescription principles, treat illness connecting with particular syndrome. Prescription principles developed from formulas, being the springing of TCM. Formulas and principles have an intimate relationship, showing off on the following aspects: creating formulas, wielding formulas and analyzing formulas according to principles, and formulas manifesting principles conversely. Then the thesis makes clear the conception of prescription means, and differentiates it from therapy means and principles. In addition, the thesis discusses the principles, structures and variation of formulas. Part three is the conception of nourishing blood means and principles to composing formulas. Nourishing blood means signifies using drugs to enriching blood to treat blood deficiency syndrome. The thesis reviews all the studying of blood deficiency syndromes from antiquity to contemporary age, provides comprehensive and effective therapy guidance to treat syndrome of blood deficiency on the basis of both traditional and modern medicine. Moreover, the thesis discusses the etiology and pathogenesis, the clinical expressions of blood deficiency syndrome, and differentiates it from similar syndromes, setting apart its main syndrome and minor syndromes, major expressions and secondary expressions. By means of studying formulas compatibility and syndrome of blood deficiency, we go step further to discuss the prescription principles of nourishing blood. Generally speaking, we choose drugs for enriching blood to treat syndrome of blood deficiency, however, when one is in the condition of collapse due to massive hemorrhage, we can give drugs for replenishing Qi as main drugs in formulas at the aim of arresting bleeding and producing blood. Drugs for enriching blood can also be of supplementary medicine, and we can select drugs for replenishing Qi, drugs for nourishing Yin, drugs for warming Yang, drugs for activating blood circulation, drugs for supplementing essence and drugs for tranquilizing Mind. According to the following theories: the promoting formation of Blood, body fluid and blood from the same source, treating yang for curing yin disease, removing blood stasis to producing new blood, essence and blood derived from the same source, blood nourishing Shen, we could choose adjuvant drugs, such as drugs for regulating Qi, drugs for exterior syndrome, drugs for clearing away heat, drug更多还原