基于扎根理论对孙洁运用“玄府气液理论”治疗小便不利经验的研究

Study on the Experience of SUN Jie with“Theory of Sweat Pore”in Treating Dysuria Based on the Grounded Theory

[目的]认识“玄府气液理论”及其与小便不利的关系,并借此探究孙洁主任运用“玄府气液理论”治疗小便不利的临床经验。[方法]通过扎根理论的研究方法,分析并构建运用玄府气液理论来辨证治疗小便不利疾病的理论模型,纳入孙洁临床诊疗数据库中收录的135例“小便不利”相关临床资料,使用扎根理论方法,进行开放式编码、关联式编码、核心式编码的三级编码分析,归纳出核心属类并构建理论框架。[结果]归纳出孙洁主任“注重玄府虚实,通化玄府,宣通气液”这一核心属类,以及“以玄府为核心的辨证论治”和“以通化玄府为治则”两大范畴,并以此为基础得出孙洁主任辨治小便不利相关疾病的经验,即以玄府为核心,注重辨玄府之虚实以及邪滞性质,以祛邪通玄及补虚通玄为治法,遣方用药以苓桂剂为核心,将利水通玄与温通玄府法相结合,善用通阳化气药。[结论]在研究和总结“玄府气液理论”的基础上,总结孙洁主任运用该理论治疗小便不利的经验,成功构建孙洁主任运用“玄府气液理论”治疗小便不利疾病的理论模型。

[Objective Objective]To understand“theory of sweat pore(Xuanfu)”and its relationship with dysuria,as well as explore Professor SUN Jie’s clinical experience in using“theory of sweat pore”to treat dysuria.[Methods Methods]Through the research method of grounded theory,this paper analyzed and constructed a theoretical model that used“theory of sweat pore”to differentiate and treat the dysuria.The clinical documents of 135 cases of“dysuria”came from Professor SUN Jie’s clinical diagnosis and treatment database.Besides,according to the qualitative research method by grounded theory,it concluded the core and built the theoretical framework by the three-level coding analysis.[Results Results]This study concluded that Professor SUN Jie summarized his experience to conclude the core category of“paying attention to the deficiency and excess of sweat pore,regulating and promoting Qi and body fluid”.Two categories of“treatment based on syndrome differentiation with theory of sweat pore”and“treatment based on the principle”of dredging and assisting sweat pore were extracted.Based on this,Professor SUN Jie’s experience in distinguishing and treating dysuria was derived,which focused on syndrome differentiation and treatment with sweat pore and on distinguishing the deficiency and stagnation of sweat pore and the nature of evil stagnation,and establishing treatment principle of dredging and assisting sweat pore,dispelling evil and supplementing deficiency as the treatment method.When using herbs,he used the prescriptions represented by Cassia Twig and Poria Cocos as the core,and combined alleviating water to dredge and assist sweat pore,warming and dredging to assist sweat pore,particularly good at using herbs of activating Yang.[Conclusion Conclusion]Based on the research and summary of“theory of sweat pore”,this paper summarized Professor SUN Jie’s experience in using“theory of sweat pore”to treat dysuria,and constructed a theoretical model for Professor SUN Jie’s use of“theory of sweat pore”in the treatment of dysuria.