【摘要】：目的本研究通過對老師“調(diào)五臟以安脾胃”的脾胃病學(xué)術(shù)思想、臨證治驗(yàn)進(jìn)行較全面、系統(tǒng)的整理,對老師治療消化性潰瘍用藥規(guī)律進(jìn)行數(shù)據(jù)挖掘研究,以期總結(jié)、傳承和升華老師的脾胃病論治學(xué)術(shù)思想,并為臨床辨證論治脾胃病提供一定的經(jīng)驗(yàn)借鑒。方法本研究以師承學(xué)習(xí)過程中的體悟、跟師臨證記錄、老師授課資料、老師公開發(fā)表的論文及公開出版的論著及其他繼承人發(fā)表的對老師臨證經(jīng)驗(yàn)、學(xué)術(shù)思想總結(jié)的論文為主,參考相關(guān)流派及各醫(yī)家的不同觀點(diǎn),從消化性潰瘍中西醫(yī)研究進(jìn)展、老師學(xué)術(shù)淵源、老師調(diào)五臟安脾胃學(xué)術(shù)思想及應(yīng)用、老師獨(dú)特的遣方用藥特色、老師消化性潰瘍用藥規(guī)律等方面作為研究內(nèi)容進(jìn)行研究。第一部分消化性潰瘍中西醫(yī)研究進(jìn)展中,采用文獻(xiàn)綜述方法,從西醫(yī)對消化性潰瘍病因病機(jī)及治療的研究、中醫(yī)對消化性潰瘍的病因病機(jī)、分型論治、中藥抗幽門螺旋桿菌作用研究現(xiàn)狀及中醫(yī)藥提高潰瘍愈合質(zhì)量的研究現(xiàn)狀方面作了較為詳盡的梳理和分析；第二部分學(xué)術(shù)淵源中,將老師所遵從的脾胃學(xué)說之淵源以年代久近之時(shí)間脈絡(luò)分三階段進(jìn)行了梳理,并結(jié)合老師的主要學(xué)術(shù)思想進(jìn)行分析,找到了老師學(xué)術(shù)思想之源流；第三部分老師“調(diào)五臟以安脾胃”學(xué)術(shù)思想、遣方用藥特色及脾胃病診療經(jīng)驗(yàn)總結(jié)中,采用了文獻(xiàn)分析研究方法,結(jié)合中醫(yī)傳統(tǒng)經(jīng)典理論從脾胃納化五臟相關(guān)、“五臟之邪皆通脾胃”之生理病理觀、重視飲食、大便、體質(zhì)的脾胃病辨證觀、“調(diào)五臟以安脾胃”的治病觀、調(diào)補(bǔ)脾腎、消補(bǔ)兼施的藥物養(yǎng)生觀及老師獨(dú)特的遣方用藥特色等方面系統(tǒng)整理和總結(jié)老師辨治脾胃病的學(xué)術(shù)思想和經(jīng)驗(yàn)；第四部分老師治療消化性潰瘍用藥規(guī)律研究中,以中醫(yī)傳承輔助系統(tǒng)(Ⅵ.1)軟件平臺(tái)為基礎(chǔ),收集、整理、篩選了老師治療消化性潰瘍120首首診處方,建立老師臨床診療消化性潰瘍信息采集的結(jié)構(gòu)化病歷模板,錄入用藥信息,形成老師治療消化性潰瘍病歷處方數(shù)據(jù)庫,利用軟件中數(shù)據(jù)分析模塊中的“方劑分析”、“統(tǒng)計(jì)報(bào)表”功能,采用關(guān)聯(lián)規(guī)則、復(fù)雜系統(tǒng)熵聚類等無監(jiān)督數(shù)據(jù)挖掘方法,從單味藥頻次、藥對、多味藥三個(gè)層面及組方規(guī)律和新處方進(jìn)行研究分析。結(jié)果通過對老師學(xué)術(shù)淵源研究,明確了《內(nèi)經(jīng)》樹立的“脾主運(yùn)化,胃主受納”、“人以胃氣為本”、“人以水谷為本”的思想以及《傷寒雜病論》確立的辨證論治的思維方法為老師脾胃論學(xué)術(shù)思想奠定了堅(jiān)實(shí)的理論基礎(chǔ)；李杲創(chuàng)立的脾胃學(xué)說、錢乙奠定的小兒脾胃學(xué)說、王好古提出的陰證論、葉天士創(chuàng)立的胃陰學(xué)說、繆仲淳治脾陰虛之“甘涼滋潤養(yǎng)陰”法及吳澄的“芳香甘平補(bǔ)中養(yǎng)陰”法等為王老師臨床診治脾胃病提供了深厚的理論依據(jù)；薛己侶導(dǎo)的“人以脾胃為本”、張景岳主張的“治脾胃即所以安五臟”、羅天益重視各臟器對脾胃的影響及鄧鐵濤教授提出的“五臟相關(guān)學(xué)說”為老師“調(diào)五臟以安脾胃”的治病觀提供了確鑿的借鑒經(jīng)驗(yàn)；《內(nèi)經(jīng)》中病因與病位的有關(guān)論述及高錦庭的外科“部位辨證”思想,為老師按濕邪所居上、中、下部位和臟腑辨治濕瘡具有簡潔而有效的指導(dǎo)作用：《內(nèi)經(jīng)》提出“治未病”的理論及李中梓倡導(dǎo)的“脾為后天之本,腎為先天之本”論,是老師將調(diào)補(bǔ)脾腎、消補(bǔ)兼施貫穿于養(yǎng)生保健、抗衰防老以治未病為核心的養(yǎng)生觀念之淵源。在第三部分對老師辨治脾胃病的研究表明老師基于脾胃納化五臟相關(guān)及“五臟之邪皆通脾胃”之生理病理觀,臨證時(shí)重視“調(diào)五臟以安脾胃”的脾胃病治療觀。老師主張臨證論治脾胃病必須著眼于肝、肺、心、腎,以平衡脾胃為要,包括調(diào)理脾胃,宜先達(dá)肝；疏脾益胃,宜先泄肺補(bǔ)肺：溫補(bǔ)脾土,宜振心腎。臨證時(shí)老師又重視脾胃的生理作用和病理影響,認(rèn)為“調(diào)五臟以安脾胃的治病觀”不只限于脾胃病,而是可廣泛用于其它系統(tǒng)疾病的治療,如“按部位和臟腑辨治濕瘡”時(shí)濕在上部,治肺為先,宣氣以助脾化濕：濕在中部,治肝脾為主,理氣以助脾燥濕；濕在下部,治腎為重,化氣以助脾利濕即是該學(xué)術(shù)思想的具體運(yùn)用。老師崇尚仲景、東垣,借鑒敦煌醫(yī)學(xué)及敦煌古方,形成了經(jīng)方時(shí)方并重的獨(dú)特遣方特色,結(jié)合自身的臨證經(jīng)驗(yàn)總結(jié),創(chuàng)擬治療脾胃病的系列經(jīng)效良方,如治療消化性潰瘍的溫中愈潰湯、養(yǎng)陰愈潰湯、疏肝愈潰湯、散寒愈潰湯等等；老師還注重發(fā)揮中藥專長及相佐配伍以提高療效,按照組方原理和配伍要求靈活使用升降并調(diào)、寒熱并舉、剛?cè)嵯酀?jì)、補(bǔ)通兼顧、收散并行等相佐配伍組方規(guī)律,驗(yàn)之臨床,療效顯著。老師自擬方疏肝和胃湯之疏肝理氣、和胃降逆法治療胃食管反流病,化瘀消痞湯之健脾和胃、行氣化瘀法治療慢性萎縮性胃炎,溫中愈潰湯之溫補(bǔ)脾胃、抑酸清肝法治療消化性潰瘍均為老師調(diào)五臟安脾胃治病觀及獨(dú)特遣方用藥特色的體現(xiàn)。另外,老師還倡導(dǎo)調(diào)補(bǔ)脾腎、消補(bǔ)兼施以治未病為核心的藥物養(yǎng)生觀,并以此為指導(dǎo)從“敦煌石窟遺書”中化裁而成了敦煌石窒大寶膠囊,用藥精當(dāng)、配伍嚴(yán)謹(jǐn),突出脾腎雙補(bǔ)、消補(bǔ)兼施在延緩衰老中的作用。在第四部分基于關(guān)聯(lián)規(guī)則和熵聚類算法的老師治療消化性潰瘍用藥規(guī)律研究表明,老師治療消化性潰瘍120首處方所用藥物頻次規(guī)律由高到低前11位依次為海螵蛸117、浙貝母110、炙甘草97、黃芪83、白芍82、桂枝70、蒲公英69、茯苓59、黃連52、紅景天51、吳茱萸49；老師治療消化性潰瘍常用三大類藥物：第一類為溫中補(bǔ)虛藥物(黃芪、白芍、桂枝、茯苓、紅景天、吳茱萸等),出現(xiàn)頻率占前11位的58.54%,每味藥的常用劑量分別為黃芪15～25g、白芍12～15g、桂枝6～12g、茯苓15～30g、紅景天15g、吳茱萸10g；第二類為中和胃酸藥物(海螵蛸、浙貝母),出現(xiàn)頻率占前11位的27.05%,每味藥的常用劑量分別為海螵蛸30～50g、浙貝母12g；第三類為清熱祛濕藥物(蒲公英、黃連),出現(xiàn)頻率占前11位的14.41%,每味藥的常用劑量分別為蒲公英10～12g、黃連3～5g;藥物四氣中溫性+熱性占所有藥物出現(xiàn)頻率的54.01%,而寒性+涼性出現(xiàn)頻率占30.46%,溫?zé)崴幍氖褂妙l次、頻率遠(yuǎn)大于寒涼藥；五味情況甘味出現(xiàn)頻率占34.18%,苦味出現(xiàn)頻率占26.73%,辛味出現(xiàn)頻率占21.46%,遠(yuǎn)多于酸味、咸味、澀味藥物；所使用藥物的歸經(jīng)頻率居于前六位的是脾、胃、肝、肺、心、腎,累積頻率達(dá)88.90%,其中歸脾胃經(jīng)占42.16%、歸肝經(jīng)占16.87%、歸肺經(jīng)占14.27%、歸心經(jīng)占9.12%、歸腎經(jīng)占6.48%；常用藥對配伍主要有三類：寒溫配伍(蒲公英-桂枝、蒲公英-海螵蛸、浙貝母-桂枝等)頻率占47.08%；甘溫配伍(桂枝-海螵蛸、紅景天-桂枝、桂枝-吳茱萸等)頻率占35.34%；苦寒配伍(浙貝母-蒲公英、蒲公英-紅景天、蒲公英-白芍等)頻率占17.68%。對以上結(jié)果分析顯示,藥物數(shù)據(jù)挖掘結(jié)果充分體現(xiàn)了老師對本病病因病機(jī)、治療方法、藥物選擇及配伍等方面的認(rèn)識(shí)。老師認(rèn)為本病病位在胃,與肝脾密切相關(guān)；病機(jī)為本虛(脾胃虛弱)標(biāo)實(shí)(濕熱、氣郁、血瘀等),故而止酸、健脾溫中、清熱除濕、行氣活血為其主要治法；又因具體臨床中本病多見寒瘍(脾胃虛寒),老師認(rèn)為治療寒瘍宜溫補(bǔ)及補(bǔ)托,故溫中補(bǔ)虛藥出現(xiàn)頻次最高,達(dá)58.54%,而且此類藥物常用劑量也較大；再結(jié)合四性、五味頻次統(tǒng)計(jì)分析,說明老師溫中補(bǔ)虛重在甘辛溫補(bǔ)——甘溫益氣以健脾養(yǎng)胃,并少佐辛散助運(yùn)之品以防滯脾呆胃；中和胃酸類藥物中海螵蛸、浙貝母居于全部三類藥頻次第一、二位,而且海螵蛸劑量為最大30-50g,藥對組合挖掘也顯示老師治療消化性潰瘍多用烏貝散(烏賊骨、浙貝母)來制酸止痛,均說明老師認(rèn)為本病發(fā)生與胃酸之過度分泌密切相關(guān)及“無酸無潰瘍”的觀點(diǎn),治療時(shí)應(yīng)止酸取效;結(jié)合歸經(jīng)分析可見老師治療本病選藥以直達(dá)脾胃為先,同時(shí)結(jié)合宣肺、達(dá)肝、溫心腎,注重“調(diào)五臟以安脾胃”以提高療效；藥對配伍中除甘溫配伍較多(達(dá)35.34%)外,寒溫配伍出現(xiàn)頻率也很高(達(dá)47.08%),體現(xiàn)了老師認(rèn)為本病因病程較長、易于復(fù)發(fā)等,故而多有寒熱錯(cuò)雜證,治療用藥時(shí)宜寒溫并用,但老師臨證時(shí)更注重甘溫配伍,忌過投純寒之藥,以顧護(hù)脾胃之氣。老師臨床治療本病常用苦寒藥頻次最高者為蒲公英和黃連,且用量均不大,蒲公英大多為10g,黃連僅為3～5g,且多與溫?zé)崴幣湮槭褂?如蒲公英伍桂枝、蒲公英伍紅景天、蒲公英伍吳茱萸、黃連伍桂枝等,及藥物配伍甘溫+寒溫出現(xiàn)頻率為82.42%,遠(yuǎn)高于苦寒配伍(17.58%)均體現(xiàn)了老師忌寒涼、護(hù)脾胃的思想。老師認(rèn)為脾胃病(包括消化性潰瘍)的發(fā)生除脾胃虛弱之本虛外,脾胃氣機(jī)壅滯、升降失常為必有之病變,病久則由于久病入絡(luò)而又有兼血瘀為患,故行氣活血的治療也必不可少,老師常用枳殼、香附、甘松、三七、川芎、當(dāng)歸等行氣活血藥與健脾、清熱藥脾胃取效。結(jié)論老師所遵從的脾胃學(xué)說淵源深厚,老師辨治脾胃病的主要學(xué)術(shù)思想傳承脈絡(luò)清晰；老師臨證論治脾胃病倡導(dǎo)五臟相關(guān)脾胃納化及升降生理觀、“五臟之邪皆通脾胃”病理觀、重視飲食口味、大便、體質(zhì)的脾胃病辨證觀、“調(diào)五臟以安脾胃”的治病觀、調(diào)補(bǔ)脾腎消補(bǔ)兼施的藥物養(yǎng)生觀及崇尚仲景、東垣、借鑒敦煌及藥物相佐配伍提高療效的組方用藥特色,形成了老師獨(dú)特的脾胃病學(xué)術(shù)體系;老師治療消化性潰瘍選用藥物時(shí)緊扣本病病位在胃,與肝脾密切相關(guān),及病機(jī)為本虛標(biāo)實(shí),發(fā)病與胃酸過度分泌密切相關(guān),而以止酸、健脾溫中、清熱除濕、行氣活血為主要治法,并注重“調(diào)五臟以安脾胃”以提高療效；老師在具體治療本病時(shí)尤重溫中補(bǔ)虛,強(qiáng)調(diào)溫中補(bǔ)虛重在甘辛溫補(bǔ),忌過投純寒之藥,以顧護(hù)脾胃之氣。
[Abstract]:OBJECTIVE To summarize, inherit and sublimate the teacher's academic thought on spleen and stomach diseases, and to provide evidence for the treatment of spleen and stomach diseases by syndrome differentiation. Methods This study was based on the experience of teachers in the process of learning, the records of teachers'clinical symptoms, the materials of teachers' teaching, the papers published by teachers, the papers published by other heirs, and the papers summarized from the experience of teachers'clinical symptoms and academic thoughts. The research contents include the research progress of traditional Chinese and Western Medicine on sexual ulcer, the academic origin of teachers, the academic thought and application of regulating the five zang-zang organs and calming the spleen and stomach, the special prescription and medication characteristics of teachers, and the medication regularity of peptic ulcer. The etiology, pathogenesis and treatment of ulcer, the etiology and pathogenesis of peptic ulcer, the classification and treatment of peptic ulcer, the research status of anti-Helicobacter pylori effect of traditional Chinese medicine and the research status of improving the quality of ulcer healing of traditional Chinese medicine have been combed and analyzed in detail; the second part of the academic origin, the teacher followed the spleen and stomach theory The origin is sorted out in three stages according to the time course of the past and the main academic thoughts of the teacher are analyzed to find the origin of the teacher's academic thoughts. According to the classical theory of traditional Chinese medicine, it systematically arranges and summarizes the physiology and pathology view of spleen and stomach, the syndrome differentiation view of spleen and stomach disease of diet, stool, constitution, the treatment view of regulating five Zang-organs to calm spleen and stomach, the view of tonifying spleen and kidney, the view of nourishing health with drugs of digesting and tonifying, and the special characteristics of the teacher's prescriptions and medicines. Conclusion The teacher's academic thought and experience in the treatment of peptic ulcer. The fourth part of the teacher's treatment of peptic ulcer law of medication research, based on the Chinese Medicine Inheritance and assistance system (VI.1) software platform, collection, collation, screened the teacher's treatment of peptic ulcer 120 first prescriptions, to establish the teacher's clinical diagnosis and treatment of peptic ulcer information collection structure. Form the prescription database of the teacher's peptic ulcer case history by transforming the template of the medical record and inputting the medication information. Use the function of "prescription analysis" and "statistical report form" in the data analysis module of the software, adopt unsupervised data mining methods such as association rules, complex system entropy clustering and so on, from three levels and groups of single drug frequency, drug pairs and multi-flavor drugs. Results Through the study of teachers'academic origin, it was clear that the thought of "spleen governs transportation, stomach governs acceptance", "human being is based on stomach qi", "human being is based on water valley" and the thought method of syndrome differentiation and treatment established by "theory of typhoid fever and miscellaneous diseases" laid a solid foundation for the teacher's academic thought of spleen and stomach theory. The solid theoretical basis, Li Zhu's spleen-stomach theory, Qian Yi's spleen-stomach theory, Wang Haogu's Yin Syndrome theory, Ye Tianshi's Stomach-yin theory, Miao Zhongchun's "Ganliang Nurturing Yin" method for treating Spleen-Yin deficiency and Wu Cheng's "Aromatic Ganping Buzhong Nurturing Yin" method provide profound theories for the clinical diagnosis and treatment of Spleen-stomach diseases. According to Xue's "people are based on the spleen and stomach", Zhang Jingyue's "treating the spleen and stomach is therefore safe five zang-organs", Luo Tianyi attaches great importance to the influence of various organs on the spleen and stomach and Professor Deng Tietao's "five Zang-organs related theory" provides a solid reference experience for the teacher's "regulating the five Zang-organs to calm the spleen and stomach"; Causes and diseases in the "Internal Classics" The related exposition and Gao Jinting's thought of "part syndrome differentiation" in surgery have succinct and effective guiding function for teachers to treat dampness sores according to damp pathogens, middle and lower parts and viscera: the theory of "treating disease before treatment" put forward by "Neijing" and Li Zhongzi's theory of "spleen is acquired, kidney is congenital" advocated by the teacher will regulate and invigorate the spleen and kidney, and eliminate it. In the third part, the research on the differentiation and treatment of spleen and stomach diseases shows that the teacher attaches importance to the treatment of spleen and stomach diseases based on the physiological and pathological view that spleen and stomach are related to the absorption of the five Zang-organs and the evil of the five Zang-organs is connected with the spleen and stomach. Teachers advocate that the treatment of spleen and stomach disease must focus on the liver, lung, heart, kidney, to balance the spleen and stomach, including regulating the spleen and stomach, should first reach the liver; soothing the spleen and stomach, should first vent the lung and tonify the lung: warming the spleen and invigorating the heart and kidney. Gastric diseases, but can be widely used in the treatment of other system diseases, such as "according to the location and viscera treatment of dampness sores" when damp in the upper, treatment of the lung first, Xuanqi to help the spleen and dampness: dampness in the middle, treatment of the liver and spleen based, regulating Qi to help the spleen dry dampness; dampness in the lower, treatment of the kidney as the most important, and Qi to help the spleen and dampness is the specific application of this academic idea. Zhongjing, Dongyuan, drawing lessons from Dunhuang medicine and ancient Dunhuang prescriptions, formed a unique prescription characteristics of both classical prescriptions and times, combined with their own clinical experience, to create a series of effective and effective treatment of spleen and stomach diseases, such as the treatment of peptic ulcer Wenzhong Yukui decoction, Yangyin Yukui decoction, Shugan Yukui decoction, Sanhan Yukui decoction, etc. According to the principle of prescription and the requirement of compatibility, flexible use of ascending and descending and adjusting, cold and heat, rigidity and softness, complementation and relaxation, and concurrent collection and dispersal of drugs can improve the curative effect. The methods of invigorating spleen and stomach, activating qi and stasis to treat chronic atrophic gastritis, warming up the spleen and stomach, inhibiting acid and clearing the liver to treat peptic ulcer are all manifestations of the teacher's view of regulating the five zang-zang organs, calming the spleen and stomach, and the unique characteristics of prescriptions. As a guide, Dunhuang Shisui Dabao Capsule was made from Dunhuang Grotto Relics. It was used properly, with strict compatibility, highlighting the role of spleen-kidney double-tonic, eliminating and reinforcing both in delaying senility. The first 11 drugs used in 120 prescriptions of peptic ulcer were Octopus 117, Fritillaria thunbergii 110, Radix Glycyrrhizae 97, Radix Astragali 83, Radix Paeoniae Alba 82, Ramulus Cinnamomi 70, Taraxacum 69, Poria Cocos 59, Coptis chinensis 52, Rhodiola 51 and Evodia rutaecarpa 49 in turn. The first three drugs were commonly used in the treatment of peptic ulcer by teachers: warming and tonifying deficiency drugs (Astragalus membranaceus, Radix Paeoniae Paeo Ling, Rhodiola, Evodia rutaecarpa and so on, the frequency of occurrence accounted for 58.54% of the top 11, the common doses of each herb were Astragalus 15-25 g, Paeonia lactiflora 12-15 g, Cinnamomum cinnamomi 6-12 g, Poria cocos 15-30 g, Rhodiola 15 g, Evodia rutaecarpa 10 g, the second kind of neutralizing gastric acid drugs (Octopus japonicus, Fritillaria thunbergii), the frequency of occurrence accounted for 27.05% of the top 11 Octopus cuttlefish 30-50g, Fritillaria thunbergii 12g; the third category is heat-clearing and dampness-removing drugs (dandelion, Coptis chinensis), the frequency of occurrence of the first 11 14.41%, the common doses of each drug are 10-12g, Coptis chinensis 3-5g; the four-gas temperature + heat of drugs accounted for 54.01% of all the frequency of the occurrence of drugs, while cold + cool frequency accounted for 30.46%, thermophilic drugs caused The frequency of sweet taste was 34.18%, bitter taste was 26.73%, spicy taste was 21.46%, much more than sour taste, salty taste and astringent taste; the frequency of meridian attribution was 88.90% in the top six drugs, including spleen, stomach, liver, lung, heart and kidney, and 42.16% in the spleen and stomach meridian. Liver meridian accounted for 16.87%, lung meridian for 14.27%, heart meridian for 9.12%, kidney meridian for 6.48%; compatibility of cold and temperature (dandelion-cinnamon twig, dandelion-cuttlebone, Fritillaria thunbergii-cinnamomi twig, etc.) accounted for 47.08%; compatibility of sweet and warm (cinnamon twig-cuttlebone, rhodiola-cinnamon twig, cinnamon twig-evodia) accounted for 35.34%; compatibility of bitter and cold (Zhejiang Fritillaria twig-cinnamomordica rutaecarpa) accounted for 47.08%. The frequency of Fritillaria-Dandelion, Dandelion-Rhodiola, Dandelion-Paeony and so on was 17.68%. The analysis of the above results showed that the results of drug data mining fully reflected the teacher's understanding of the pathogenesis, treatment methods, drug selection and compatibility of the disease. Weakness (dampness and heat, Qi stagnation, blood stasis, etc.), so the main treatment is to stop acid, invigorate the spleen and warm up, clear away heat and dampness, and promote qi and blood circulation; and because of the specific clinical manifestations of the disease are often cold sores (spleen and stomach deficiency cold), the teacher thinks that the treatment of cold sores should be warm tonic and tonic, so the frequency of tonic drugs in the temperature is the highest, up to 58.54%, and the dosage of such drugs is also large; Combined with the statistical analysis of four properties and five flavors frequency, it shows that the teacher's warmth in tonifying deficiency in Ganxin Wenbu-Ganwenyiqi to invigorate the spleen and nourish the stomach, and less Zuoxin powder to prevent stagnation of the spleen and stomach; in neutralizing gastric acid drugs, cuttlebone, Fritillaria thunbergii occupies the first and second place in the frequency of all three kinds of drugs, and the maximum dose of cuttlebone is 30-50g, the combination of drugs. Digging also showed that the teacher treated peptic ulcer with Wubeisan (squid bone, fritillary Fritillaria thunbergii) to make acid analgesia, indicating that the occurrence of the disease is closely related to the excessive secretion of gastric acid and "no acid no ulcer" point of view, treatment should be acid effect; combined with meridian analysis can be seen that the teacher treatment of the disease to the spleen and stomach first drug selection, at the same time Combination of Xuanfei, liver, warm heart and kidney, pay attention to "regulating the five viscera to calm the spleen and stomach" to improve curative effect; drug pairs compatibility in addition to the more compatibility of sweet and warm (35.34%), cold and warm compatibility frequency is also high (47.08%), reflects that the teacher thinks that the cause of the disease is longer, easy to recur, so there are many cold and heat miscellaneous syndrome, treatment should be cold and warm, but Teachers pay more attention to the compatibility of sweet and warm, avoid the use of pure cold medicine, to protect the spleen and stomach Qi. Teachers clinical treatment of this disease often used the highest frequency of bitter and cold medicine for dandelion and coptis, and dosage is not large, most of the dandelion is 10 g, Coptis is only 3-5 g, and more with warm medicine compatibility, such as dandelion Wuguizhi, dandelion Wu Hongjingtian, dandelion The frequency of occurrence of Evodia rutaecarpa, Coptis chinensis and Cinnamomum cassia, and drug compatibility of Gan Wen and Han Wen was 82.42%, much higher than that of bitter cold compatibility (17.58%). The teacher thought that the occurrence of spleen and stomach disease (including peptic ulcer) was not only the weakness of the spleen and stomach, but also the stagnation of spleen and stomach Qi and the abnormality of ascending and descending were the necessary pathological changes. The treatment of Qi and blood stasis is indispensable for a long time. Teachers often use Fructus Aurantii, Rhizoma Cyperi, Gansong, Panax Notoginseng, Ligusticum Chuanxiong, Angelica sinensis and other Qi and Blood-activating drugs to invigorate the spleen, and Qingre drugs to improve the spleen and stomach. Teachers advocate the five viscera-related spleen and stomach absorption and ascending and descending physiology, the "five viscera evil all pass spleen and stomach" pathological view, pay attention to dietary taste, stool, constitution of spleen and stomach disease syndrome differentiation, "adjust the five viscera to calm the spleen and stomach" treatment view, adjust the spleen and kidney Xiaobu and admire Zhongjing, Dongyuan, draw lessons from Dunhuang and drugs The unique academic system of spleen and stomach diseases has been formed by the combination of prescriptions to improve the curative effect. As the main treatment, and pay attention to "regulating the five Zang-organs to calm the spleen and stomach" to improve the curative effect; the teacher in the specific treatment of this disease, especially in the revision of the deficiency, emphasize warming in the tonic
【學(xué)位授予單位】：中國中醫(yī)科學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R259

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