郭宪章主任医师治疗慢性腰腿痛用药规律分析

摘要

目的:探讨郭宪章主任医师治疗慢性腰腿痛的遣方用药规律.方法:收集郭宪章主任医师2014—1015年治疗慢性腰腿痛的内服药处方197份, 运用方剂计量学方法, 对其用药范围、性味、归经和功效等进行规律分析.结果:郭宪章治疗慢性腰腿痛以补益肝肾、祛湿通络、化瘀止痛为主, 方剂中以炒杜仲、川牛膝、生甘草、川续断、当归、威灵仙、赤芍、桃仁、红花、淫羊藿使用频次最高, 药味以苦、辛、甘为主;药性以温、平、寒为主, 药物归经以肝经、脾经、肾经为主.结论:郭宪章治疗慢性腰腿痛时辨病辨证相结合, 强调肝肾亏虚、经络失养、经气不利、气滞血瘀、脉络不通、不通则痛是该病病机的关键, 为临床治疗该病提供用药参考及研究思路.%Objective:To discuss the rules of the prescription and medicine used by chief physician Guo Xianzhang in treating chronic lumbocrural pain. Methods: All 197 prescriptions used by chief physician Guo Xianzhang for chronic lumbocrural pain from 2014 to 2015 were collected, the rules of administration range, nature and flavors, channel tropism and effects were analyzed by using prescription metrology. Results:Director Guo Xianzhang treated chronic lumbocrural pain by tonifying liver and kidney, eliminating dampness and dredging the collaterals, eliminating blood stasis and stopping the pain mainly, the using frequencies of fried DuZhong (Eucommia ulmoides Oliver), ChuanNiuXi (radices cyathulae), raw GanCao (liquorice), Chuan XuDuan (Dipsacus asperoides C. Y. Cheng et T. M. Ai), DangGui (Angelica sinensis), WeiLingXian (Clematischinensis), ChiShao (Radix Paeoniae Rubra), TaoRen (Semen Persicae), HongHua (Carthamus tinctorius L.) and YinYangHuo (Epimedium brevicornu Maxim.) were the highest in the prescriptions, the flavors of the herbs were bitter, acrid and sweet mainly; the natures were warm, mild and cold mainly, the channel tropisms were liver, spleen and kidney mainly. Conclusion:Director Guo Xianzhang combines disease differentiation with syndrome differentiation when he treats chronic lumbocrural pain, he emphasizes that "liver and kidney depletion, loss of meridians and collaterals, disorder of meridian-Qi, Qi stagnation and blood stasis, pulse obstruction, obstruction causing pain"are the key of the pathogenesis of the disease, which could provide medication reference and research thinking for clinical therapy.