近代中西医汇通派医家张锡纯与恽铁樵临证用药方剂计量学研究

Metrological Study on ZHANG Xichun and YUN Tieqiao of School of Integrative Medicine Characteristics in Using Medicines

目的:通过对比民清时期9位医家临证处方规律的异同点,分析探讨中西医汇通派张锡纯、恽铁樵两位医家临证处方用药特色。方法:选择张锡纯、恽铁樵及其他7位医家临证医案为研究对象,运用传统文献学方法、方剂计量学方法,对各医家临证处方用药的常用药物四性五味归经补泻运用情况进行方剂计量学特有指标对比分析。结果:中西医汇通医家临证处方用药排序前5位的药物包括炙甘草、白术、白芍、茯苓、当归,具有气血并补,补中有泻之意,多以补气阳为主,恽铁樵偏补阴血。两位医家用药偏寒凉,辛甘。张锡纯与中西医汇通医家中唐容川及陆渊雷相关性显著,相关系数分别为0.826,0.701(P<0.05),与其他医家均不显著(P均>0.05),聚类分析显示中西医汇通派医家张锡纯、唐容川、陆渊雷可聚为一类,恽铁樵单独一类,其他非汇通医家不为同类。结论:两医家临证处方同中有异,皆为攻补兼施,张氏偏补后天脾胃,恽氏更重先天精血。

Objective ： Through the comparison of 9 medical clinic prescription rules of similarities and differences, analysis of School of Integrative Medicine was represented by ZHANG Xichun and YUN Tieqiao. ZHANG Xichun, YUN Tieqiao and other 7 doctors＇ clinic medical records were selected for the study. The traditional literature metrology methods were used for analyzing all physicians＇ commonly - used drugs. School of Integrative Medicine doctors in clinical medication sorted top 5 drugs,including licorice, bighead atractylodes rhizome and Poria, Radix paeoniae Alba, Angelica. These can nourish blood and mainly supplement Yang. ZHANG Xichun and YUN Tieqiao used cold medicines. The medication of ZHANG Xichun and TANG Rongchuan had significance, correlation coefficients were respectively 0. 826,0. 701 （ P 〈 0.05 ）. The cluster analysis revealed doctors of School of Integrative Medicine by ZHANG Xichun, TANG Rongchuan and LU Yuanlei were the same category and YUN Tieqiao was the other category. Other non - School of Integrative Medicine physicians were not homogeneous. Conclusion：ZHANG Xichun and YUN Tieqiao of School of Integrative Medicine have their similarities of medication as well as their own characteristics. ZHANG Xichun paid attention to tonifying spleen and stomach while YUN Tieqiao paid more attention to the congenial essence and blood.