温胆汤及其类方治疗情志病证的文献研究

Modern Literature Research on the Distribution Characteristics and Pathogenesis of Gallbladder-Warming Decoction and its Analogy Prescriptions

目的:通过对现代文献的研究,进一步总结温胆汤及其类方治疗情志病证的证候分布特征,并探讨其病机特点。方法:收集近30年温胆汤及其类方治疗以神志症状为主的情志病证的临床文献中病种、症状、证候类型等信息,采用频数分析的统计学方法进行处理,并结合中医学理论,对结果进行整理、统计与分析。结果:纳入文献的共涉及6个病种,出现频率最高的为不寐,其次为癫狂、郁证;共涉及115个主要临床症状,出现频率最高的为入睡困难、其次为烦躁、食欲不振、口苦、胸闷、头晕、多梦、心悸、泛恶欲吐等;舌象共涉及10种舌质、12种舌苔、4种舌形,其中出现频率最高的为舌苔腻,其次是舌苔黄、舌质红;脉象以脉滑为主,其次是脉弦、脉数;证候类型共涉及12个,其中以痰热内扰证出现频率最高,其次为痰火扰神证。结论:温胆汤及其类方治疗情志病证的证候分布具有一定的规律与特征,病机为气机失调、痰热内阻,兼有心神被扰,与相关研究中的治疗规律相契合,体现了中医辨证与论治较好的对应关系。

Objective ：Through the study of modern literature, we further sum up the syndrome distribution characteristics of Gall- bladder-Warming Decoction and analogy prescriptions in treating emotional diseases, and explore its pathogenesis characteristics. Methods .The clinical literatures on Gallbladder-Warming Decoction and its analogy prescriptions in treating types, symptoms, syn- dromes of emotional diseases in the past 30 years were collected, and processed by using statistical methods of frequency analysis; the results were arranged and statistically analyzed by combining with the theory of traditional Chinese medicine. Results ：Six types of disease were involved into the literature, and the highest frequency was insomnia, followed by mania, depression. A total of 115 main clinical symptoms were involved, the highest frequency was the difficulty to fall asleep, followed by irritability,loss of appe- tite, bitter mouth, chest tightness, dizziness, dreaminess, palpitation, vomiting, etc. A total of 10 kinds of tongue nature, 12 kinds of tongue fur, and 4 kinds of tongue shapes were involved into tongue condition, and the highest frequency was greasy tongue fur, fol- lowed by yellowish fur, then reddish tongue fur. The pulse condition is mainly manifested as pulse, followed by string-like pulse and rapid pulse, There were 12 syndromes in which the frequency of phlegm heat disturbance was the highest, followed by phlegm fire disturbing the heart. Conclusion：The syndrome distribution of Gallbladder-Warming Decoction and analogy prescriptions in treating emotional diseases has certain rules and characteristics. The pathogenesis is disorder of qi-activity, phlegm-heat blocking inside the body, combined with the mind being disturbed, which is in accordance with the rules of treatment in relevant studies, re- flects on the good relationship between TCM syndrome differentiation and treatment.