文章摘要
姚维佳,周天梅.桂枝加厚朴杏子汤治疗神经科疑难杂症经验[J].浙江中医药大学学报,2021,(1):56-59.
桂枝加厚朴杏子汤治疗神经科疑难杂症经验
Experiences in the Treatment of Intractable Diseases of Nervous System with Guizhi and Houpo Xingzi Decoction
投稿时间:2020-06-20  
DOI:10.16466/j.issn1005-5509.2021.01.011
中文关键词: 桂枝加厚朴杏子汤  头痛症  多发性抽动症  失眠症  疑难杂症  周天梅  医案  临证经验
英文关键词: Guizhi and Houpo Xingzi decoction  headache  Tourette syndrome  insomnia  intractable disease  ZHOU Tianmei  medical cases  clinical experience
基金项目:国家中医药管理局第四批全国中医(临床、基础)优秀人才研修项目(中国中医药人教发[2017]24号)
作者单位E-mail
姚维佳 浙江中医药大学附属广兴医院 杭州 310007  
周天梅 浙江中医药大学附属广兴医院 杭州 310007 ztm729@126.com 
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中文摘要:
      [目的]总结周天梅教授临床应用桂枝加厚朴杏子汤治疗神经科疑难杂症的经验。[方法]通过跟师随诊并查阅其医案,选取周师治疗头痛症、多发性抽动症、失眠症之验案3则,并结合历代名家的相关论述,从病因病机、辨证论治、用药特点等方面,分析总结周师应用桂枝加厚朴杏子汤治疗神经科疑难杂症的学术观点及临床经验。[结果]周师认为临床运用桂枝加厚朴杏子汤需抓住外邪困表、里热攻冲这一病机,只要辨证准确,此方不仅可用来治疗肺系疾病,也可用来治疗神经科疑难杂症。所举头痛症、多发性抽动症、失眠症医案,以外邪困表、里热攻冲为主要病机,可见头痛、鼻炎或双手抽动等表束症状,怕热或口干口苦等里热症状,刻诊均可见下眼睑色半白半红、下肢血络或甲错之里热伤血的表现,治以桂枝加厚朴杏子汤解表清热,调和营卫气血,临床疗效确切。[结论]周天梅教授从外邪困表、里热攻冲出发,灵活运用桂枝加厚朴杏子汤治疗神经科疑难杂症,临床疗效肯定,值得学习和推广运用。
英文摘要:
      [Objective] To summarize the experience of Professor ZHOU Tianmei in treating intractable diseases of nervous system with Guizhi and Houpo Xingzi decoction. [Methods]Through following Professor ZHOU Tianmei in clinical works and consulting Professor ZHOU’s clinical cases, three medical records of headache, Tourette syndrome(TS) and insomnia were selected. Combined with the related discussions of famous experts in the past dynasties, Professor ZHOU’s thoughts and experience of using Guizhi and Houpo Xingzi decoction to treat intractable diseases of nervous system were summarized from the aspects of etiology and pathogenesis, syndrome differentiation treatment, prescriptions, medication characters. [Results] Professor ZHOU Tianmei believes that in the clinical application of Guizhi and Houpo Xingzi decoction, it is necessary to grasp the pathogenesis of exogenous pathogenic factors invading exterior and heat attacking interior, Guizhi and Houpo Xingzi decoction can not only be used to treat pulmonary system diseases but also nervous system diseases as long as the syndrome differentiation is accurate. Especially in the treatment of headache, TS and insomnia, it should start from the pathogenesis of exogenous pathogenic factors invading exterior and heat attacking interior, so as to resolve the exterior and clear heat, harmonize Yin and Yang, and the curative effect is distinct and rapid.The main pathogenesis of the cases was that exogenous pathogenic factors invading exterior and heat attacking interior. The symptoms of exogenous pathogenic factors invading exterior were headache, rhinitis, or hands twitching, etc., and the symptoms of that heat attacking interior were fear of heat, dry mouth or bitter taste in the mouth, etc. The common symptoms of the cases were half white and half red lower eyelid, obvious lower limbs' blood vessels, or the rough skin of lower limbs. The patient achieved good results after treated with Guizhi and Houpo Xingzi decoction to resolve the exterior and clear heat, harmonize Yin and Yang, nutrient and defense, Qi and blood. [Conclusion] Professor ZHOU Tianmei treats intractable diseases of nervous system with Guizhi and Houpo Xingzi decoction from the point of exogenous pathogenic factors invading exterior and heat attacking interior. The clinical effect was positive, and it was worth learning and applying.
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