《名医类案》《续名医类案》湿热证辨治规律探讨

Discussion on the Law of Distinguishing and Treating Dampiness and Heat Syndrome in Famous Medical Cases and Continuing Famous Medical Cases

目的通过对《名医类案》《续名医类案》中湿热证医案的统计整理,总结其辨治湿热证的经验,为现代临床辨治湿热证提供借鉴和参考。方法筛选《名医类案》《续名医类案》湿热证医案177例,将医案相关信息录入Excel表格,采用IBM SPSS Statistics 20统计软件进行频数运算;运用IBM SPSS modeler 18统计软件进行关联规则运算,运用中医药理论对统计结果进行分析。结果在177例湿热证病案记录中,共涉及症状92种,常见症状有局部红肿热痛、但热不寒、肢体疼痛等;方剂86首,常用方剂为补中益气汤、龙胆泻肝汤、二陈汤等;药物188种,常用药物有白术、当归、茯苓等。得到有意义的症状→症状二阶关联组27组,方剂→药物二阶关联组27组。结论《名医类案》《续名医类案》诊断湿热证,重在辨别湿邪与热邪之偏重、病位表里之深浅以及邪正虚实之盛衰,治以清热利湿、健脾燥湿之法。其重视人身正气,在驱邪之际注重兼顾补益气血是其辨治的特色。

Objective To summary the experience of distinguishing and treating dampiness and heat syndrome in Famous Medical Cases and Continuing Famous Medical Cases,and provide reference for modern clinical distinguishing and treating dampiness and heat syndrome.Methods 177 cases of dampiness and heat syndrome medical cases of Famous Medical Cases and Continuing Famous Medical Cases were selected,relevant information of medical cases were inputted into Excel,and IBM SPSS Statistics 20 statistical software was used for frequency calculation;IBM SPSS modeler 18 statistical software was used to calculate association rules,and the statistical results were analyzed with the theory of traditional Chinese medicine.Results In the records of 177 cases of dampiness and heat syndrome,92 kinds of symptoms were involved,and the common symptoms were local redness,swelling,heat and pain,but not cold,limb pain and so on;86 prescriptions were involved,and the commonly used prescriptions were Buzhong Yiqi Decoction,Longdan Xiegan Decoction,Erchen Decoction,etc;188 kinds of drugs were included,and commonly used drugs were Baizhu(Atractylodis Macrocephalae Rhizoma),Danggui(Angelicae Sinensis Radix),and Fuling(Poria),etc.Significant symptom→symptom second-order association group 27 and prescription→drug second-order association group 27 were obtained.Conclusion The diagnosis of dampness heat syndrome in Famous Medical Cases and Continuing Famous Medical Cases is focused on the distinguishing the excessive emphasis of dampness-evil and heat-evil,the depth of the disease table,and the rise and fall of the evil,the deficiency and the reality,and the treatment of the method of clearing the heat,promoting the dampness and invigorating the spleen and dampness.Its characteristics of syndrome differentiation and treatment are that it attaches great importance to the healthy Qi of the human body and pays attention to both nourishing Qi and blood when exorcising evil spirits.