文章摘要
罗慧佳,刘靖晗,王伟杰,等.白塞病的辨治思路探析[J].浙江中医药大学学报,2021,(5):518-520, 564.
白塞病的辨治思路探析
Analysis on Thoughts and Methods of Syndrome Differentiation for the Treatment of Behcet′s Disease
投稿时间:2021-02-20  
DOI:10.16466/j.issn1005-5509.2021.05.015
中文关键词: 白塞病  狐惑病  辨证论治  湿火  升阳散火  清肝降火  补肾平火  病案
英文关键词: Behcet's disease  Huhuo disease  treatment based on syndrome differentiation  dampness and fire  raise Yang and disperse fire  clear the liver and reduce fire  tonify the kidney and subside fire  medical records
基金项目:浙江省中青年临床名中医培养项目(浙中医药[2017]27号)
作者单位E-mail
罗慧佳 浙江中医药大学第二临床医学院 杭州 310053  
刘靖晗 烟台市烟台山医院  
王伟杰 浙江中医药大学附属第二医院  
黄继勇 浙江中医药大学附属第二医院 huangjy99@163.com 
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中文摘要:
      [目的]总结探析白塞病的辨证和治疗思路。[方法]通过临床跟诊,从病因病机、临床辨证分型、治疗原则和遣方用药特色等方面总结分析白塞病的辨治思路,并附验案一则以佐证。[结果]白塞病的发病本质是湿火气郁难消,伤及血脉皮肉。据临床经验,本病主要分为风毒湿火证、肝郁湿火证和阴虚湿火证三型,宜从湿火论治,以泻火除湿为基本治法。其中风毒湿火证治以疏风解毒、散火祛湿,方选甘草泻心汤加减;肝郁湿火证治以清肝降火、祛湿解郁,方选龙胆泻肝汤合加味逍遥散加减;阴虚湿火证治以补肾润肺、养阴平火,方选知柏地黄汤合沙参麦冬汤加减。所举验案患者辨证为风毒湿火证,治以疏风解毒、散火祛湿,药对相参,病情稳定控制。[结论]从湿火论治白塞病,体现出中医紧扣病机、灵活用药、随证治之的治疗原则,取得了良好的疗效,具有临床实用价值。
英文摘要:
      [Objective] To summarize and analyse the thoughts and methods of syndrome differentiation for the treatment of Behcet's disease.[Methods] Through clinical study, thoughts and methods of syndrome differentiation of Behcet's disease were summarized and analyzed from the aspects of the etiology and pathogenesis, clinical syndrome differentiation, principles of treatment and characteristics of prescription, which were validated in the way of a medical record.[Results] The essence of Behcet's disease was the dampness and fire that was difficult to dissipate and caused damage to the flesh and blood. And the disease can be divided into three syndrome types which were syndrome of wind-toxicity with dampness and fire, liver-depression with dampness and fire, as well as Yin-deficiency with dampness and fire according to clinical experience, and it was taken the method of expelling dehumidification and purging fire as the basic treatment and should be treated from dampness and fire. Modified Gancao Xiexin Decoction was used in syndrome of wind-toxicity with dampness and fire to dispel wind pathogens and clear away toxic material, disperse fire and expel dehumidification, and Longdan Xiegan Decoction combined with modified Jiawei Xiaoyao Powder were used in syndrome of liver-depression with dampness and fire to clear and reduce liver-fire, expel dehumidification and relieve depression, and Zhibai Dihuang Decoction combined with modified Shashen Maidong Decoction were used in syndrome of Yin-deficiency with dampness and fire to tonify the kidney and moisture the lung, nourish Yin and subside fire. The patient's syndrome in the medical record was syndrome of wind-toxicity with dampness and fire, and treatment principles were dispelling wind pathogens and clearing away toxic material, dispersing fire and expelling dehumidification, and drugs were suitable for syndrome, and the patient's disease condition was stable and under control. [Conclusion] Thoughts and methods of syndrome differentiation for Behcet's disease from dampness and fire reflect the idea of principles of treatment on emphasizing pathogenesis, using drugs flexibly and adopting diagnostic methods, achieve great curative effect and have excellent practical value clinically.
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