清代御医曹沧洲治咳医案用药规律探析
Research on the Imperial Physician CAO Cangzhou's Prescription Regularity of Treatment for Cough in Qing Dynasty
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摘要: 目的 探讨清代御医曹沧洲治咳用药规律。方法 选取治咳医案157案,进行用药频次统计、关联分析,选取有病机或治法记载的医案110案,进行病机归纳与对应用药频次统计。结果 治咳核心药物是杏仁;常用药物有冬瓜子、浙贝、茯苓、蛤壳、桑叶、枇杷露、丝瓜络、橘白等14味;常用药对有杏仁-浙贝、杏仁-冬瓜子、紫菀-杏仁、紫菀-浙贝4组;常用3药组合有浙贝-冬瓜子-杏仁、白前-冬瓜子-杏仁、桑叶-冬瓜子-杏仁、紫菀-浙贝-杏仁、茯苓-浙贝-杏仁等9组,分别具有清热化痰、疏风、润肺、健脾之功效。主要病机有痰热郁肺、肺阴受损、肾不纳气、脾湿中阻、木火刑金、痰火扰心等14种,对应不同病机,又有针对性用药。结论 曹沧洲治咳秉承温病学派思想,用药平和,质地偏润,药性偏凉,治疗以祛邪为主,注重养护阴津。Abstract: OBJECTIVE To explore the prescription regularity of treatment for cough of Cao cangzhou, an imperial physician in Qing Dynasty. METHODS A total of 157 cough cases in Cao cangzhou were included in the study. Spss moderler 14.1 was used for correlation analysis and frequency statistics. Viscera syndrome differentiation of 110 medical records was also carried out. RESULTS The core drug is xingren. The commonly used 14 drugs include dongguazi, xiangbei, fuling, geke, sangye, pipalu, sigualo, jubai, et al. The couplet medicines are xingren-zhebei,xingren-dongguazi,ziwan-xingren, ziwan-zhebei. 9 groups of three drug combinations are zhebei-dongguazi-xingren, baiqian-dongguazi-xingren, sangye-donggauazi-xingren, ziwan-zhebei-xingren, fuling-zhebei-xingren, et al, which are effective in clearing heat and expectoration, dispersing wind-heat, regulating the flow of vital energy, and strengthening the spleen. The types of symptoms are tanreyufei,feiyinshousun, shenbunaqi, pishizhongzu, muhuoxingjin, tanhuoraxin, etc. There are corresponding medicine to different symptoms. CONCLUSIONS Inheriting the academic thought on treating warm-induced febrile diseases, his treatment is mainly based on dispelling evil and paying attention to nourishing yin. His medicine is cool and the texture is moist.