明清医家治疗不孕症的用药特点研究

Study on the characteristics of medication used by medical experts to treat infertility in the Ming and Qing dynasties

目的:探究明清医家治疗不孕症的用药特点。方法:利用《中华医典》光盘(第5版)检索明清医案古籍,筛选符合要求的不孕症医案,归纳医案并建立Excel数据库;运用统计软件对中医症型、证素分布、中药频次等进行描述性统计。结果:得到符合要求的不孕症医案72个,包括证型40个,拆分得到病位14个、病性17个。分析结果显示,气血两虚证频次最高,其次是肾阳虚证、肾阴虚证、肝郁脾虚证;主要病位在肾、脾、肝;主要病性为气虚、血虚、精亏;药物主要归脾、肝、肾经;主要有调经止痛、润肠通便、安胎等功效;所用中药主要为温性、甘味。结论:明清不孕症多为虚证。治疗上,明清医家多考虑药物的归经来用药;多用甘味性温的药物;喜用当归养血助孕;对于气虚不孕者,善用健脾养血药达到补气目的。

Objective:To explore the characteristics of medicine used by doctors in the Ming and Qing dynasties to treat infertility.Method:A total of 72 infertility medical cases were screened by searching ancient medical cases of Ming and Qing dynasties using the CD ROM of Chinese Medical Classics(5th edition).After summarizing medical cases an Excel database was established,and descriptive statistics were made on traditional Chinese medicine(TCM)syndrome type,syndrome element distribution,TCM frequency by statistical software.Results:There were 40 syndrome types,which were divided into 14 disease locations and 17 diseases.The analysis results showed that the frequency of Qi and blood deficiency syndrome was the highest,followed by kidney-Yang(肾阳)deficiency syndrome,kidney-Yin(肾阴)deficiency syndrome,liver stagnation and spleen deficiency syndrome.The main disease locations were in kidney,spleen and liver,and the main diseases were Qi deficiency,blood deficiency and Jing-deficiency(精亏).The main effects of TCM are regulating menstruation and relieving pain,moistening intestines and relieving constipation,and preventing miscarriage.Conclusion:Infertility in the Ming and Qing dynasties was mostly deficiency syndrome.In terms of treatment,doctors in the Ming and Qing dynasties paid more attention to the meridian tropism of drugs,used sweet and warm drugs,and preferred to use Angelica sinensis to nourish blood and help pregnancy.For those who were sterile due to Qi deficiency,they were good at using spleen invigorating and blood nourishing drugs to replenish Qi.