蒲辅周治内科病的用药特点研究

Research on Characteristics of PU Fuzhou Treating Internal Diseases

目的:研究蒲辅周治疗内科病的用药特点,探索四川地区的医家用药是否具有地域性特点。方法:整理《蒲辅周医案》、《蒲辅周医疗经验》的复方118首,用Excel和Access建立数据库,应用《中药复方分析系统》软件研究其用药特点。结果:使用药物涉及20类,使用频次为30次及以上依次为补虚、利湿、行气、解表、清热、化痰、化湿、安神、消食、平肝潜阳、祛风湿、活血化瘀、温里、收敛固涩药;单味药物使用频次15次及以上依次为甘草、茯苓、陈皮、法半夏、白术、大枣、生姜、厚朴、枳实、茵陈、通草、白芍、化橘红、酸枣仁、蒺藜、党参、薏苡仁、神曲、远志、杏仁;药对居前10位多为上述药物的排列组合,其中使用频次10次及以上依次(不含甘草)为茯苓与陈皮、茯苓与白术、茵陈与通草、法半夏与陈皮、茯苓与法半夏、薏苡仁与茵陈、远志与酸枣仁、法半夏与化橘红、法半夏与白术、陈皮与白术、生姜与大枣、党参与白术、薏苡仁与通草。结论:1蒲老治内科病以顾护胃气为本;强调"天人相应"观,用药注重地域与体质,擅用除湿化痰之品;配行气与消食药以协祛湿之效;伍补益药使祛湿不伤正。2除湿化痰药(化湿药、利湿药、祛风湿药、化痰药)之比约为2∶4∶1∶2,显示蒲老治疗湿邪为患首选利湿之品,其目的是给邪以出路,合"治湿不利小便,非其治也"之旨。

Objective ： To research the characteristics of drug therapy of treating the internal diseases by PU Fuzhou. To explore if there is any regional distinguishing feature of the way Siehuan TCM doctors treatment the disease. Methods：118 compound prescriptions used by PU Fuzhou were collected by using the Excel and Access to set up database and the software of Traditional Chinese Medicine Compound Analysis System was used to research the characteristics of drug therapy. Results：The use of drug involved 20 species and the use of frequency reached more than 30 times, namely, drugs for complementing deficiency, drugs for removing dampness through dieresis, drugs for promoting the circulation of Qi, drugs for relieving exterior syndrome, heat - clearing drug, phlegm - reducing medicine, resolving dampness drugs, tranquilizingdrugs, dispersing drugs, subduing liver and restraining Yang drugs, removing blood stasis drugs, drugs for dispelling internal cold,astringency. Single drugs used more than 15 time were licorice,poria cocos ,dried tangerine peel,rhizoma pinelliae, atractyiodes, chinese - date, ginger, officinalis, trifoliate, capillary artemisia, tetrapanax papyriferus, paeoniae, red tangerine peel, wild jujube benevolence, terrestris, codonopsis pilosula, coix, medicated leaven, polygala tenuifolia, almond. Couplet medicines ranked in the top 10 were the above drug combinations, in which the frequency of use more than 10 （except liquorice） were poria cocos and dried tangerine peel, poria cocos and atractyiodes, capillary Artemisia and tetrap- anax papyriferus, rhizoma pinelliae and dried tangerine peel, peria cocos and rhizoma pinelliae, coix and capillary artemisia, polygala tenuifolia and wild jujube benevolence, rhizoma pinelliae and red tangerine peel, rhizoma pinelliae and atractyiodes, dried tangerine peel and atractyiodes, ginger and chinese - date, codonopsis pilosula and atractyiodes, coix and tetrapanax papyriferus. Conclusions：（1） The basis of PU Fuzhou treatment method of medical illnesses is to take care and protect the Qi of the stomach, emphasizing the ideology of man and nature as well as the correspondence of man and nature. He also gave importance to the difference regions and body build, good at using the medicines that can dehumidify and reduce the phlegm, combined with drugs for promoting the circulation of Qi and dispersing so as to minimize the damage to the body but still reaching the objective of dehumidification. （2）The group of dehumidification and phlegm reduction medi- cine consists of resolving dampness drugs, drugs for removing dampness through dieresis, medical herbs and phlegm reduc- tion medicine and the ratio is 2 ： 4 ： 1 ： 2. It is an example that PU Fuzhou prefers using the dehumidification drugs with the intention of finding the exit for Xie - Qi. There is no other wag to dispel the dampness without dieresis.