文章摘要
徐裕坤,孙洁,岑秉融,等.基于质性研究之扎根理论探究王坤根名老中医辨治湿热类证阳痿特点[J].浙江中医药大学学报,2021,(2):142-145.
基于质性研究之扎根理论探究王坤根名老中医辨治湿热类证阳痿特点
Based on the Grounded Theory of Qualitative Research to Explore the Characteristics of WANG Kungen’s Differentiation and Treatment of Erectile Dysfunction with Dampness-heat Syndrome
投稿时间:2020-04-15  
DOI:10.16466/j.issn1005-5509.2021.02.008
中文关键词: 阳痿  质性研究  扎根理论  湿热  医案  王坤根  名医经验
英文关键词: erectile dysfunction  qualitative research  grounded theory  dampness-heat  medical record  WANG Kungen  experience of eminent doctor
基金项目:2017年河南省科技研发项目(162102310019)
作者单位
徐裕坤 浙江中医药大学附属第三医院 杭州 310005 
孙洁 浙江中医药大学附属第三医院 杭州 310005
浙江中医药大学第一临床医学院王坤根名中医工作室 
岑秉融 浙江中医药大学附属第三医院 杭州 310005 
黄培 浙江中医药大学附属第三医院 杭州 310005 
杨德威 浙江中医药大学附属第三医院 杭州 310005 
龚瑜轩 浙江中医药大学附属第三医院 杭州 310005 
赖孟超 浙江中医药大学附属第三医院 杭州 310005 
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中文摘要:
      [目的]探究王坤根名老中医辨治湿热类证阳痿病的特点。[方法]使用质性研究及其分支扎根理论研究方法,对王坤根老中医临床诊疗数据库(2010至2016年)中符合纳入、排除标准的病案进行三级编码:先通过开放性编码进行无预设分析,经主轴编码锚定中心思路后,再以选择性编码充实框架,最终得到王坤根老中医论治湿热类证阳痿的辨治特点。[结果]王坤根老中医临床诊疗数据库分析得到开放性编码372个,锚定研究重心为“湿热类证”后,重新编码,并整理出主轴编码17个,最终形成5个选择性编码:清热法、化湿法、清热利湿、清利疏肝和补肾法。基于三级编码,构建出王坤根名老中医辨治湿热类证时,以针对病机用药为核心思路,据证合用诸法,再兼专症专药的阳痿病诊治理论模型。[结论]王坤根名老中医辨治湿热类证时,以针对病机用药为核心思路,据证合用诸法,再兼专症专药的阳痿病诊治理论模型。王坤根名老中医论治湿热类证阳痿的辨治特点是以针对病机用药为核心,在清热祛湿基础上,据证活用凉血、疏肝、活血、补肾诸法,以治疗湿热类证阳痿。对于重要兼症佐以专药,同时结合阳痿病的特征,治以起阳诸品。基于扎根理论的质性研究方法能系统而深入地发掘名老中医经验,但需要研究人员具有较好的研究素养和中医药专业知识。
英文摘要:
      [Objective] To explore the characteristics of the famous doctor of traditional Chinese medicine(TCM) WANG Kungen’s differentiation and treatment of erectile dysfunction(ED) with dampness-heat syndrome. [Methods] Using qualitative research and grounded theoretical research methods, the medical records of WANG Kungen’s clinical diagnosis and treatment database of TCM(2010 to 2016) in line with the acceptance and discharge standards were coded in three levels. After extensive analysis through open coding, it anchored the central idea through spindle coding, and then enriched the framework with selective coding, the theoretical model of the character of treating dampness-heat ED was finally obtained. [Results] After 372 open codes were obtained, “dampness-heat syndrome” was anchored as the core concentration. Thus 17 main axis codes were recorded and sorted out. Finally 5 selective codes were obtained, such as the heat-clearing method, the dampness-dissipating method, the method of eliminating dampness and heat, the method of soothing the liver and clearing dampness-heat, and the kidney nourishing method. Taking the methods of three levels coding, it constructed the treating model of ED by WANG Kungen. The core idea was pointing at pathogenesis, and then combined with various treating methods and medicine to treat it. [Conclusion] On the basis of clearing away heat and removing dampness, WANG Kungen takes medication for pathogenesis as the core idea, uses the methods of cooling blood, dispersing the liver, promoting blood circulation and tonifying the kidney to treat ED patients with damp heat syndrome. Some specific medicines are prepared for some important symptoms. Also medicine to dredge Yang Qi can be applied, according to the character of ED. Grounded theory and qualitative research has a great effect in digging the experience of eminent doctor deeply and systematically, but it calls for an excellent research ability and professional knowledge of TCM.
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