隋唐以来10位著名医家汗证学术思想初探

Exploration on the Academic Thoughts of Ten Famous Doctors on Sweating Syndrome Since Sui and Tang Dynasties

目的研究隋唐以来10位著名医家关于汗证的文献,以期为临床治疗提供参考。方法收录刘完素、张从正、李东垣、朱震享、孙思邈、张景岳、王清任、叶天士、张元素、吴鞠通10位医家关于汗证的133条方证论述,按照著作名称、医家姓名、临床症状、病因病机、辨证分型、治疗用方、治疗用药等条目,分别输入Microsoft Excel 2007建立数据库;采用SPSS 17.0统计软件的频数分析方法,统计各病因病机、辨证分型、治疗用方、治疗用药、临床症状频数及频率。结果感受外邪、素体薄弱为主要病因病机,肺卫不固、阴虚火旺、湿热郁蒸为主要证型,使用频次较高的药物是甘草、黄芪、人参、当归、桂枝、白术,出现频率较高的症状是自汗、盗汗,黄汗、脱汗、战汗则较少。结论感受外邪和素体薄弱为引起汗证的两大主要因素,以肺卫不固型最为多见,桂枝加黄芪汤和玉屏风散化裁为临床常用方剂,益气固表、滋阴清热之药最为常用。

Objective To provide reference for the clinical treatment based on the literature study of ten famous doctors on sweating syndrome since Sui and Tang Dynasties. Methods Collected 133 prescription and discussion on sweating syndrome of 10 doctors including LIU Wansu,ZHANG Congzheng,LI Dongyuan,ZHU Zhenheng,SUN Simiao,ZHANG Jingyue,WANG Qingren,YE Tianshi,ZHANG Yuansu,WU Jutong,and respectively input them into Microsoft Excel 2007 to establish the database according to the title of the work,doctors name,clinical symptoms,cause of disease and pathological mechanism,pattern differentiation,treatment,medication and so on; adopted the frequency analysis method with SPSS 17. 0 to make the statistics of the frequency on the cause of diseases and pathological mechanism,pattern differentiation,prescriptions and medications,and clinical symptoms. Results The exogenous evil and body weakness are the main causes and pathological mechanisms; insecurity of lung-defense,fire excess from yin deficiency,and damp-heat stagnating and evaporating are the main patterns. Medicinals with higher frequency are licorice,astragalus,ginseng,angelica,cassia twig,white atractylodes. Symptoms with higher frequency are spontaneous sweating,night sweats,while yellow sweat,shock sweating and shiver sweating are of lower frequency. Conclusion exogenous evil and body weakness are the two main factors causing sweating syndrome,insecurity of lung-defense being the most common. Huangqi and Guizhi Decoction and Yupingfeng Powder are the most frequently used prescriptions; medicinals on tonifying yin and consolidating exterior are most commonly used.