丁甘仁外科医案辨证规律初探
Study on Syndrome Differentiation Rules of Ding Ganren's Case Records in External Medicine
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摘要: 目的 分析丁甘仁医案著作中外科病案的辨证规律。方法 采用Apriori算法建模,对丁氏外科医案进行关联规则分析,并结合传统的文献研究及频数统计,探索丁氏外科的辨病、辨证特色。结果 丁氏外科医案中疽为优势病种,痈、骨槽风、瘰疬等病也较为常见。与《中医外科学》中辨证对比,丁氏对疽的辨证更注重里证,而非表里同病;丁氏对大头瘟的辨证以表实热证为主要证型,而非内热证。此外,丁氏医案中辨证为血虚气滞或阴亏气滞的病案比气滞血瘀、痰瘀互结、气血两虚等常规外科证型更为常见。结论 丁甘仁外科医案所体现的辨证规律对当下外科疾病的辨证具有重要的参考价值;阴血亏与气滞两种病机的并存多出现在瘤、癌、瘰疬、附骨疽等病案中,反映了丁氏对“因虚而滞”和“因滞而虚”两种病变机理的认识,丰富了中医气血关系的理论,扩充了中医外科辨证的思路。Abstract: OBJECTIVE To analyze the syndrome differentiation rules of Ding Ganren's case records in external medicine. METHODS Association rules analysis on Ding's case records in external medicine was performed with modeling established by Apriori algorithm. Disease and syndrome differentiation characteristics of Ding's case records in external medicine was explored combined with conventional literature research and frequency statistics. RESULTS Cellulitis was a dominant disease in Ding's case records in external medicine, abscess, maxillary osteomyelitis and scrofula were also common. Compared with the syndrome differentiation in Chinese Traditional Surgery, Ding paid more attention to internal syndrome rather than identified the interior and exterior in the syndrome differentiation of cellulitis. Ding took exterior excess heat syndrome as the main syndrome of infectious swollen head rather than interior heat syndrome. In addition, the cases that were differentiated as blood deficiency and qi stagnation or yin deficiency and qi stagnation were more common than conventional external syndromes such as qi stagnation and blood stasis,phlegm and blood stasis binding and dual deficiency of qi and blood. CONCLUSION The differences of the common surgical diseases syndrome differentiation of Ding and Chinese Traditional Surgery reflect Ding's unique experience in exterior and interior syndrome differentiation. The coexistence of yin and blood deficiency and qi stagnation usually occurs in Ding's case records in external medicine such as tumor, cancer, scrofula and suppurative osteomyelitis, which reflects Ding's understanding about lesion mechanisms of "deficiency resulting in stagnation" and "stagnation resulting in deficiency". This enriches the TCM theory of relationship between qi and blood, expands the thinking of TCM syndrome differentiation in external medicine.
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[1] 沈仲理.丁甘仁临证医集[M].上海:上海中医药大学出版社,2000. [2] SHEN ZL. DING Ganren's Clinical Records Anthology[M]. Shanghai: Publishing house of Shanghai university of Chinese medicine, 2000. [3] 丁甘仁.孟河丁甘仁医案[M].北京:学苑出版社,2012. [4] DING GR. Medical Records of DING Ganren from Menghe Area[M]. Beijing: Academy press, 2012. [5] 丁甘仁.丁氏百病医方大全[M].福州:福建科技出版社,2010. [6] DING GR. DENG Ganren's Complete Volume of Medical Prescription[M]. Fuzhou: Fujian science and technology press, 2010. [7] 陈红风.中医外科学[M].北京:人民卫生出版社,2013. [8] CHEN HF. Surgery of Traditional Chinese Medicine[M]. Beijing: People's medical publishing house, 2013. [9] 吴兰成.中国中医药学主题词表[M].北京:中医古籍出版社,2008. [10] WU LC. China Thesaurus of Traditional Chinese Medicine[M]. Beijing: TCM ancient books publishing house, 2008.
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