本文選題：消化性潰瘍 + 柏樹綱教授��； 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：消化性潰瘍(PU)是臨床消化系統(tǒng)中較為常見的一類疾病,全球人群發(fā)病率為10-12%,其以病程長(zhǎng)且反復(fù)發(fā)作為臨床特點(diǎn),本病以上腹痛為典型癥狀。目前為止尚未明確論述本病病因及發(fā)病機(jī)理。近年來西醫(yī)對(duì)檢出幽門螺旋桿菌病患進(jìn)行三聯(lián)、四聯(lián)療法治療,無幽門螺旋桿菌病患廣泛應(yīng)用胃粘膜保護(hù)劑及PPI類藥物以減少胃酸分泌、保護(hù)胃粘膜治療,目前臨床消化性潰瘍治療愈合率有所提升,但潰瘍愈合質(zhì)量尚不理想,且不良反應(yīng)多,復(fù)發(fā)率高。根據(jù)癥狀將本病歸屬中醫(yī)學(xué)“胃脘痛”,中醫(yī)治療本病具有大量經(jīng)驗(yàn),值得臨床醫(yī)生總結(jié)研究,中醫(yī)辨證施治優(yōu)勢(shì)明顯。吾師柏樹綱教授熟讀經(jīng)典,精于臨床,師承國(guó)醫(yī)大師周學(xué)文教授,基于國(guó)醫(yī)大師李玉奇教授、周學(xué)文教授的理論和實(shí)踐經(jīng)驗(yàn),對(duì)本病病因、病機(jī)、辨證、舌診、治法及組方遣藥有著獨(dú)到見解,尤其重視運(yùn)用“通消清補(bǔ)”四法治療本病。本文通過對(duì)導(dǎo)師于門診治療本病患者的經(jīng)驗(yàn)進(jìn)行整理分析,旨在梳理總結(jié)本病的病因病機(jī)、辯證思想、治療法則等。本文章第一部分是正文,正文包含前言、經(jīng)驗(yàn)論述,本文章的前言簡(jiǎn)單介紹消化性潰瘍。經(jīng)驗(yàn)論述部分對(duì)吾師于臨床治療本病過程的臨床經(jīng)驗(yàn)進(jìn)行總結(jié)。吾師提出PU發(fā)病“三因?qū)W說”即毒熱、胃弱脾虛、邪實(shí)正虛的病因。引起“毒熱”襲胃;胃氣不和,氣機(jī)失調(diào)及邪實(shí)正虛,虛實(shí)錯(cuò)雜致病。故而該病應(yīng)針對(duì)病因靈活運(yùn)用“通消清補(bǔ)”四法以組方遣藥。這為指導(dǎo)臨床治療PU提供一定的理論依據(jù)。本文是在導(dǎo)師柏樹綱教授的悉心指導(dǎo)下,對(duì)導(dǎo)師在門診治療PU患者的臨證經(jīng)驗(yàn)進(jìn)行系統(tǒng)的研究與總結(jié)(如發(fā)病誘因、病程、辨證分型、用藥特點(diǎn)等),于本文章之后舉經(jīng)典病歷一則,更以具體的表達(dá)柏樹綱教授對(duì)本病之治療經(jīng)驗(yàn)。于治療本病過程中,針對(duì)本病致病“三因”,運(yùn)用“通消清補(bǔ)”四法為主指導(dǎo)用藥,治療本病效果較好,具有臨床指導(dǎo)意義。本文章第二部分是附錄,附錄主要部分為文獻(xiàn)綜述,分別從中醫(yī)及西醫(yī)的診療方面進(jìn)行論述。
[Abstract]:Peptic ulcer (PUU) is a common disease in the clinical digestive system. The global incidence rate is 10-12. The disease is characterized by long course of disease and repeated attacks, and abdominal pain above the disease is a typical symptom. So far, the etiology and pathogenesis of the disease have not been clearly discussed. In recent years, Western medicine has been used to treat patients with Helicobacter pylori by triple therapy and tetralogy therapy. Patients without Helicobacter pylori are widely treated with gastric mucosal protectors and PPI drugs to reduce gastric acid secretion and protect gastric mucosa. At present, the healing rate of peptic ulcer has been improved, but the quality of ulcer healing is not ideal, and there are many adverse reactions and high recurrence rate. According to the symptoms, this disease belongs to the traditional Chinese medicine "epigastric pain", Chinese medicine treatment of this disease has a lot of experience, it is worthy of clinical doctors to sum up the study, TCM syndrome differentiation and treatment advantages. Professor Bo Shugang, my teacher, is familiar with the classics and is good at clinical practice. Professor Zhou Xuewen is a master of Chinese medicine. Based on the theoretical and practical experience of Professor Li Yuqi and Professor Zhou Xuewen, he has a good understanding of the etiology, pathogenesis, syndrome differentiation and tongue diagnosis of the disease. Treatment and prescription have unique views, especially pay attention to the use of "Tongxiaobingbu" four methods for the treatment of this disease. In this paper, the author analyzes the experience of the tutor in the treatment of this disease in order to sum up the etiology, pathogenesis, dialectical thought, treatment principles and so on. The first part of this article is the main body, the text contains foreword, experience exposition, the preface of this article introduces peptic ulcer briefly. In the part of experience discussion, we summarize the clinical experience of our teacher in the course of clinical treatment of this disease. Our teacher put forward the theory of "three causes" of pu, that is, toxic heat, stomach weak spleen deficiency, and evil deficiency. Causes "toxic heat" to attack the stomach; stomach qi disharmony, Qi-qi disorder and the deficiency of evil, mixed-up pathogenic. Therefore, the disease should be flexible to use the "Tongxiaobing Buu" four methods in order to form prescriptions. This provides a theoretical basis for clinical treatment of pu. This paper is a systematic study and summary on the clinical experience of the tutor in the treatment of pu patients (such as inducement, course of disease, syndrome differentiation and classification) under the careful guidance of his mentor, Professor Pao Shukang. After this article, a classic medical record is given to express Professor Cypress's experience in the treatment of the disease. In the course of treating this disease, according to the "three causes" of the disease, the four methods of "Tongxiaobingbu" are mainly used to guide the use of medicine, which has a good effect and has clinical guiding significance. The second part of this article is the appendix, the main part of the appendix is literature review, respectively from the Chinese medicine and Western medicine diagnosis and treatment.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R249;R259

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