《名医类案》产后病治验撷箐

Excerpts from"Famous Doctors'Cases"on the Treatment of Postpartum Diseases

目的:梳理挖掘《名医类案》中产后病用药特色,为现今产后病的预防及治疗提供临床参考及理论依据。方法:利用统计软件EXCEL分析产后篇涉列的63则医案及其他篇章中提及的产后医案共计12类疾病的论证治疗,分析证候分布特点,主要方剂应用频次,探讨产后病的发病机制及用药规律。结果:产后病篇应用频次3次(包括3次)以上的方剂为补中益气汤、六君子汤、十全大补汤、八珍汤、四物汤、八物汤。结论:明代以前医家治疗产后病重视健脾益气生血,强调产后气血不足的生理特点。常用健脾生血、益气化津的药物,同时少佐辛温药,以开启玄府微微发汗达到疏通经络,祛瘀生新,调和营卫、邪自外出的目的;临急症时多法并举,内服外治结合,急则治其标,缓则治其本,时刻注意顾护正气留人治病为基本大法。

Objective:To sort out and excavate the characteristics of postpartum disease medication in“Famous Doctors’Cases”to provide clinical reference and theoretical basis for the prevention and treatment of postpartum disease today.Methods:Use the statistical software EXCEL to analyze the demonstration and treatment of 12 types of diseases in 63 medical cases listed in the postpartum chapter and the postpartum medical cases mentioned in other chapters,analyze the distribution characteristics of syndromes,the application frequency of main prescriptions,and explore the incidence of postpartum diseases.Mechanism and medication rules.Results:The postpartum disease chapter was applied 3 times(including 3 times).The above prescriptions are Buzhong Yiqi Decoction,Liujunzi Decoction,Shiquan Dabu Decoction,Bazhen Decoction,Siwu Decoction,and Bawu Decoction.Conclusion:Before the Ming Dynasty,doctors paid great attention to strengthening the spleen,replenishing Qi and generating blood when treating postpartum diseases,emphasizing the physiological characteristics of postpartum deficiency of Qi and blood.Commonly used drugs are those that strengthen the spleen and promote blood,replenish Qi and transform body fluids,and at the same time use pungent and warm medicines to stimulate the Xuanfu to cause slight sweating,thus dredging the meridians,removing blood stasis and regenerating new energy,and coordinating the nutrient and health and eliminating evil.In case of emergencies,multiple methods are used at the same time.Combine internal administration and external treatment,treat the symptoms if it is urgent,treat the root cause if it is slow,and always pay attention to protecting the righteousness and leaving the patient alone to treat the disease.This is the basic method.