文章摘要
赵玲玉,何迎春.国医大师朱良春“治未病”思想在痹病临床中的应用探析[J].浙江中医药大学学报,2021,(1):23-27.
国医大师朱良春“治未病”思想在痹病临床中的应用探析
Clinical Application of “Preventive Treatment of Disease” Thoughts in Arthralgia Disease by Master of TCM ZHU Liangchun
投稿时间:2020-05-31  
DOI:10.16466/j.issn1005-5509.2021.01.004
中文关键词: 国医大师  朱良春  治未病  痹病  辨证论治  医案  名医经验
英文关键词: Master of TCM  ZHU Liangchun  preventive treatment of disease  arthralgia dsease  syndrome differentiation and treatment  medical record  famous physician's experience
基金项目:
作者单位E-mail
赵玲玉 浙江中医药大学第三临床医学院 杭州 310053  
何迎春 杭州市中医院 heyingchun2008@163.com 
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中文摘要:
      [目的]总结国医大师朱良春教授运用“治未病”思想治疗痹病的临证思路。[方法]收集学习朱老治疗痹病的病案,并查阅相关著作和文献,结合朱老对于痹病病因病机的认识,研究其临床常用药物和诊治思路,从痹病的发生、发展及转归过程角度进行阐述,并附医案一则加以佐证。[结果]关于痹病的治疗,朱老注重治病求本,临证时将辨病与辨证紧密结合。在病发之前见微知著,注重避邪扶正,巧用引经药,并将患者临床表现的高危可疑因素与现代医学理化检查指标相结合,做到未病先防;痹病发生之时,针对其病因病机,有效控制风、寒、湿、热、燥、瘀之痹的发展和传变,并遵循脏腑辨治的特点,顺应各脏腑的特点杂合以治,有效遏制五脏痹的进展;在痹病发生后期,用益肾蠲痹丸、蝎蚣胶囊等,将“从肾论治”和“善用虫药”的思维充分发挥,以巩固疗效、防止复发。所举医案患者辨为浊瘀痹,以泄浊化瘀、调益脾肾、蠲痹通络为法,注重祛湿通络药与其他药物的灵活运用,经治后患者多年痼疾告愈。[结论]朱老在痹病的治疗中善于运用“治未病”的学术思想,未病状态加强防护,已病状态注重病症统筹、标本兼顾,根据各阶段的致病特点分别加以辨证施治,其临证思路值得继承和推广,用以指导临床实践。
英文摘要:
      [Objective]To summarize the clinical thinking of Professor ZHU Liangchun, Master of traditional Chinese medicine(TCM) in treating arthralgia with the thought of “Preventive Treatment of Disease”. [Methods]Through collecting and studying the medical records of Professor ZHU in treating arthralgia disease, consulting relevant medical cases and literature, combining with Professor ZHU’s understanding of the etiology and pathogenesis of arthralgia disease, his common clinical drugs and treatment ideas were studied and elaborated from the perspective of the occurrence, development and outcome of arthralgia disease, and a medical case was attached to support it. [Results]For the treatment of arthralgia disease, Professor ZHU paid attention to treating the disease and seeking the root cause, he combined disease differentiation and syndrome differentiation closely in clinical practice. Before the occurrence of the disease, he paid attention to avoiding pathogenic factors and strengthening the healthy Qi, skillfully used meridian guiding drugs directly to the disease site and combined the high-risk suspicious factors of clinical manifestations with the physical and chemical examination indexes of modern medicine, so as to prevent the disease from occurrence. When the arthralgia disease occurred, according to its etiology and pathogenesis, he effectively controlled the development and transmission of arthralgia of wind, cold, dampness, heat, dryness and blood stasis, and followed the characteristics of syndrome differentiation and treatment of viscera. In the late stage of arthralgia disease, Yishen Juanbi pill and Xiegong capsule were used to give full play to the thinking of “treating from the kidney” and “being good at using insect drugs” to consolidate the curative effect and prevent recurrence. The patient was identified as turbidity and blood stasis, and the methods of eliminating turbidity and removing blood stasis, regulating the spleen and kidney, and removing obstruction and dredging collaterals were used, Professor ZHU attached great importance to the flexible use of drugs for removing dampness and dredging collaterals and other drugs, and after treatment, the patient recovered from the disease. [Conclusion]Professor ZHU was good at using the academic thoughts of “preventive treatment of disease” in the treatment of arthralgia disease. The disease-free state should strengthen the protection, and the state of the disease should pay attention to the overall planning of the disease, consider both manifestation and root cause of disease, and treat the disease according to syndrome differentiation, following the pathogenic characteristics of each stage. Professor ZHU’s clinical thinking was worthy of inheritance and promotion, so as to guide clinical practice.
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