摘要
目的探求产后腹痛古今病案中的病机与用药特色,为中医治疗产后腹痛提供临床指导。方法收集唐宋以来270份古今病案,分古代与近现代两个时段对病机分布与方药构成进行分析。结果古代产后腹痛以瘀血内阻证(60.74%)与气血两虚证(26.67%)为主;近现代证型相对分散,在瘀血内阻证(32.59%)、气血两虚证(29.63%)之外,尚有寒凝血脉证(20.00%)、肝郁气滞证(14.81%)等。方药构成上,古代以小复方为主,现代则以大复方为多。用药特色上,古今病案与瘀血内阻证相关的方药都以生化汤合失笑散为主,气血两虚与寒凝血脉证均以四物汤为主,但各证型在加减用药上显示出较大的差异,尤其对肝郁气滞证的治疗,古代以理气健脾药为主,近现代则以活血行气止痛为主药。结论古今名医病案对产后腹痛都从虚、瘀、寒、滞等角度予以治疗,但鉴于时代差异,古今证型分布及遣方用药同中有异,提示产后腹痛的临床治疗应结合证型特点辨证选药。
Objective： To analysis the difference between the clinical cases of ancient and modern famous Chinese physicians in the treatment of abdominal pain after abortion in order to guide clinical practices. Methods：270 cases of this kind of treatment were collected from Tang Dynasty up to now;mechanism and drug disciplines in both ancient times and modern times were systemized with statistics and computer technology. Results： Promoting blood circulation and removing stasis was the most syndrome element;the second was regulating Qi and blood in ancient times. Besides,Qi stagnation and cold coagulation were commonly seen in modern times. In prescriptions,Shenghua decoction and Shixiao decoction for dispersing blood stasis,Siwutang for regulating Qi,blood,and cold was used most in both ancient and modern times. As for Qi stagnation,replenishing Qi-invigorating spleen was different from regulating Qi-flowing for relieving pain in ancient and modern times. Conclusion：Deficiency,stasis,coagulation and stagnation were the same syndrome elements in ancient and modern times,but the prescription used in clinical treatment is changing with time.
出处
《中国中医急症》
2016年第5期784-787,841,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
国家中医药管理局与南京中医药大学省局共建项目(SJGJ030)
关键词
产后腹痛
名医病案
方药
对比分析
Abdominal pain after abortion
Clinical cases study
Prescription and medicine
Ancient and modern contrast
