基于医案浅谈王孟英运用经方的思路

WANG Meng-ying's thoughts of using classical formulas based on medical cases

目的:探讨《王孟英医案》中经方运用的思路和方法。方法:收集《王孟英医案》中经方或经方合方、经方加减治疗的病案;录入Excel建立数据库,使用SPSS 13.0进行频次统计及因子分析。总结医案中经方使用的频次、所治疗的病证及经方合方医案,方证的舌脉,组方思路。结果:所用经方共26首,小陷胸汤、白头翁汤、白虎汤频次均大于10次,经方合方运用较多。对应的舌脉多为红舌,弦滑脉的热证。因子分析提取9个公因子后,分为苦寒清热凉血、清热化痰、清热养阴、调和营卫气血、宣降肺气、滋肾阴清热、行气利水等治法。结论:王孟英使用经方多用清热类方剂,合方或加减宣降肺气化裁,配合清热化痰养阴治法,重视调理肝肺气机灵活组方。

Objective：To explore thoughts and methods of using classical formulas in WANG Meng-ying＇s Case Records.Methods：The cases using classical formulas,combined formulas and modified formulas in WANG Meng-ying＇s Case Records were collected and put into Excel to establish a database;frequency of the formulas and factor analysis were made by SPSS 13.0.Frequency of the classical formulas,diseases,cases of combined formulas,condition of tongue and pulse and thoughts for forming a formula were summarized.Results：A total of 26 formulas were used.The frequency of Xiaoxianxiong Decoction,Baitouweng Decoction,and Baihu Decoction was more than 10,with more frequent use of combined formulas.Most formulas were correspond to the heat syndrome,manifested as red tongue and string-like and slippery pulse.Nine common factors were selected,and the following methods were concluded,including clearing heat and cooling blood by bitter and cold medicine,clearing heat and resolving phlegm,clearing away heat and nourising yin,harmonizing nutritive aspect,defensive aspect,qi and blood,dispersing the lung qi,clearing heat and nourishing kidney yin,and moving qi and draining water.Conclusion：Most formulas used by WANG Meng-ying focus on clearing heat,combined with other formulas or modification and with the treatment method of clearing heat,resolving phlegm and nourishing yin.Great importance is attached to regulating qi movement of liver and lung and l exibility in forming formulas.