目的探讨朱丹溪临证用药特点,分析其医学理论与临床实践的关联性。方法运用方剂计量学的指标体系和分析方法对朱丹溪医论与医案所载方药的功效、归经、四性、五味进行统计对比,并运用相关分析等数理统计方法进行综合分析评价。结果 (1)朱丹溪在临证处方用药使用最多的依次为清热、补气、化痰、解表、理气类药物;使用归脾经、胃经药物较多,使用心经、肝经、肾经药物差别不甚明显;多用脏经药物,少用腑经药物;喜用药性为温性、寒性药物,而用凉性、热性药物较少;用苦味、辛味的药物较多,酸味、咸味药物较少。(2)临证医论与医案的药物功效相关性分析结果,相关系数r=0.917(P〈0.01);二者药物归经相关系数r=0.990(P〈0.01);药物四性相关系数r=0.996(P〈0.01);药物五味相关系数r=0.994(P〈0.01)。结论朱丹溪是滋阴派的倡导者,创立了阳有余阴不足论、相火论,临床用药善治杂病,尤其善于治疗痰证和郁证,这些理论与经验在本文对朱丹溪临证处方用药的方剂计量学分析中得到证实。朱丹溪医论与医案用药关联性极强,表明其理论与临床实践的高度统一。
Objective To explore the characteristics of the medical herbs used in the clinical by Danxi Zhu and to analyze relevance of the medical theory and clinical practice.Methods To use Index System of Prescription Metrology and Analysis Method to compare and analyze the effectiveness,meridians,four properties,five flavors of the herbs written in the medical theory and medical case records of Danxi Zhu;Correlation analysis of mathematical statistics was used to conduct a comprehensive analysis.Results(1) medical herbs widely used in the clinical by Danxi Zhu were in sequence of clearing heat,reinforcing qi,dissolving phlegm,relieving the exterior,regulating qi;most medical herbs belonging to Spleen meridian,Stomach meridian.There was no significant differences in using herbs belonging to Heart,Liver and Kidney meridian.Medical herbs belonging to zang-organ,warm,cold,bitter,pungent-spicy were more used,while fu-organ,cool,heat,sour,salty were less used.(2) the correlation coefficient of effectiveness of medical herbs r=0.917(P0.01);correlation coefficient of the meridian r=0.990(P0.01);correlation coefficient of four properties r=0.996(P0.01);correlation coefficient of five flavors r=0.994(P0.01).Conclusion Danxi Zhu is an advocator of nourishing yin school,who initiates "viewpoint of yang being in excess while yin being in deficiency" and "viewpoint of ministerial fire".He was good at treating difficult diseases especially in the phlegm and melancholia diseases.The theories and experiences in this article were confirmed by metrology analysis.The relevance of using medical herbs was very strong,and it showed that its theory and clinical practice was a high degree of unity.