【作者】 谢娟；

【导师】 瞿融；

【作者基本信息】 南京中医药大学 ， 方剂学， 2009， 博士

【摘要】 中医药在老年期痴呆(老年呆病)的防治中具有显著效果,散在丰富的文献资料为整理和发掘提供了重要数据源,可运用现代科学方法对这些文献资源进行深入地整理研究,发掘蕴藏的潜在规律,优化组方配伍来指导医师临床运用。本文即是基于数理统计方法对该病组方配伍规律的研究。论文分两部分。第一部分:数据统计。分古代、现代以及古今对比三部分,从单味药物、药物分类、药物组合角度分别列出了相应数据统计结果。第二部分:运用中医理论对统计结果进行了分析探讨。结果表明,古代治疗健忘、痴呆的方剂,在组成上以补益药和安神药为主,补益以补气为主,补血、补阴为辅,多用人参,安神以养心安神为主,重镇安神为辅,常用远志。配伍药物主要为清热药与开窍药,多用生地、菖蒲。健忘方偏于滋补心肾,痴呆方偏于温化痰湿。方剂中常见与人参、远志药物相关的补益与安神药对,以及定志(丸)、生脉(散)、四君子(汤)及类似增液(汤)类三味、四味药物组合。现代治疗老年期痴呆的方剂,在组成上以补益药为主,补益略偏补血,常用熟地、当归、首乌,兼顾阳、气、阴液,首选益智仁、黄芪、枸杞子。配伍药物主要为活血化瘀药,常用川芎、丹参、郁金;其次为清热药与开窍药。老年性痴呆注重心肾并治,血管性痴呆注重肝肾同调。方剂中常见与菖蒲、熟地、当归、川芎相关的开窍、活血、补血药对,以及以四物汤为核心的药物组合。古今方对比表明,现代方相较于古代方既有继承,也有发展变化。继承主要表现在注重补益,发展变化主要表现为安神药的比重大幅降低,而活血化瘀、平肝熄风的比重大幅提高。安神药物降低的重点表现为古代大量运用的重镇安神药物现代几乎不用;而活血化瘀与平肝熄风药物的比重大幅增高也集中表现在血管性痴呆方中。更多还原

【Abstract】 This article is based on the methods of mathematical statistics on the data of senile dementia, which can be used for these resources to conduct in-depth literature studies,to collate,to discover the laws of hidden potential,and guide the physician in the clinical use.There are two portions:the first segment is results of statistics,and the second part is analysis and discussion which is combined with theories of Chinese medicine.Ancient benefit in the treatment of senile dementia,by both supplement and calm-and-spirit, commonly used Ginseng,and Yuanzhi.While Modern treatment of senile dementia mainly benefit mainly on supplement,than promoting blood circulation.Modern treatment mainly benefit to the blood,qi,yang,yin supplement,in which numerous blood drug,the drug of choice for Qi supplement,Huangqi is preferred;for Yang supplement,Yizhiren is preferred;and for Yin supplement,Gouqizi is preferred.More sedative,like Yuanzhi are used in Alzheimer’s disease treatment than in vascular dementia.They are almost calm the spirit with nourishment, very few sedate and calm the spirit.Alzheimer’s disease re-up heart and kidneys,while vascular dementia re-up liver and kidney.Sedating the liver and Calming Wind drugs are used in vascular dementia,which focus mainly Calming Wind drugs,such as Tianma,Gouteng,with little use of drugs suppressing liver-yang.There are core combinations in ancient therapy which are Four-Noble Drug Decoction,Pluse-Generating Powder and Calming the spirit Pill,while in modern treatment that is Four-Ingredient Decoction.更多还原