基于古代文献糖尿病肾病方药探究.docVIP

基于古代文献糖尿病肾病方药探究[摘要] 本研究采用《中华医典》第四版为检索工具，通过检索糖尿病肾病相关古代文献，对其治疗方药进行梳理。共检索到方药87首，方药记载古籍年限起自唐朝止于民国。其中六味地黄丸、加减肾气丸、白茯苓丸、加减四物汤被记载引用较多。然而仅少数方药目前在临床推广应用。初步研究认为，现代医家可根据辨证论治和辨病论治两大原则应用古籍方药，但是如何让古籍方药更好的在现代临床应用仍值得进一步探究。 [关键词] 糖尿病肾病；方药；古籍研究 [中图分类号] R255.4 [文献标识码] A [文章编号] 1673-7210（2012）07（b）-0091-03 Ancient literature research on Chinese medicine formulae of diabetic neph-ropathy ZHANG Lei LIU Xusheng▲ Department of Nephropathy，Guangdong Traditional Chinese Medicine Hospital, Guangdong Province, Guangzhou 510120, China [Abstract] This research was to comb ancient Chinese medicine formulae on diabetic nephropathy by using Chinese Medical Tantras, and analyzing ancient literature. 87 ancient formulae were retrieved, which were recorded begin from the tang dynasty to the republic of China. Pill of Six Ingredients with Rehmannia, Shenqi-pill, Poria Alba Pill and Decoction of Four Drugs were recorded more frequency. However, only a handful of prescription has set up a file in the modern clinical application. It was discovered that two principles could help modern physicians using ancient formulae, that was syndrome differentiation and disease differentiation. But how to guide the clinical application of ancient formulae in modern clinic is still worth further explored. [Key words] Diabetic nephropathy; Chinese medicine formulae; Ancient literature research 糖尿病肾病是导致终末期肾脏病的主要原因。2010年我国中华医学会糖尿病学分会流行病学调查显示[1]，目前我国糖尿病人数已达9 240万人，而糖尿病伴有慢性肾脏病变的不同人群患病率为25%～60%。若如此庞大的人群进展至终末期肾脏病，将给社会和家庭带来沉重负担。多年临床经验表明，中医药在延缓糖尿病肾病进展方面具有肯定疗效。然而，中医学中并无“糖尿病肾病”病名。本课题组通过前期文献及专家咨询研究，确定糖尿病肾病属于中医“肾消”、“消肾”、“下消”范畴，并以此为检索词，以《中华医典》第四版光盘版为检索工具，对古籍文献中有关糖尿病肾病的治疗方药进行提取和归纳总结，现将结果总结报道如下： 1 检索结果概况 共检索到“肾消”相关条文191条，“下消”相关条文336条，“消肾”相关条文190条。通过条文归类及信息提取，共提取中药方剂87首。其中，六味地黄丸和加减肾气丸被古籍记载引用频次最高，分别被46部和39部古籍记载。而白茯苓丸和加味四物汤紧随其后，分别被18部和12部古籍所记载。被5～10部古籍记载的方剂有16首，4部古籍记载的方剂有7首，3部古籍记载的有14首，2部古籍记载的有23首，1部古籍记载的有23首，见表1。 87首中药方剂记载书籍年限起于唐朝止于民国，明朝记载治疗糖尿病肾病的古代方剂最多，共58首。其后由多到少依次排列为清朝、宋朝、金元、民国和唐朝。有些方剂被多个朝代古籍传载引用，如六味地黄丸和加减肾气丸均被金元、