| 王慧杰,沈悦倩,周天梅.国医大师熊继柏教授运用补肝汤经验探讨[J].浙江中医药大学学报,2021,45(6):603-606, 611. |
| 国医大师熊继柏教授运用补肝汤经验探讨 |
| Experience of Traditional Chinese Medicine Master XIONG Jibai in Application of Bugan Decoction |
| DOI：10.16466/j.issn1005-5509.2021.06.006 |
| 中文关键词: 国医大师 熊继柏 补肝汤 肝血不足 血虚生风 情志不畅 医案 临证经验 |
| 英文关键词: master of traditional Chinese medicine XIONG Jibai Bugan Decoction deficiency of the liver blood wind generated from blood deficiency depression of mood case clinical experience |
| 基金项目:国家中医药管理局“国医大师熊继柏传承工作室”建设项目(国中医药人教发[2017]29号)；国家中医药管理局第四批全国中医临床优秀人才研修项目(国中医药人教发[2017]24号) |
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| 中文摘要: |
| [目的]探讨国医大师熊继柏教授运用补肝汤治疗疑难杂症的临证经验，并寻找其运用规律，以期指导临床治疗。[方法]通过整理熊教授临证运用补肝汤医案，并查阅相关文献，分析熊教授运用补肝汤与临床常见疑难杂病的关系并分析其治病原理，找出补肝汤的临证化裁，并列举运用补肝汤治疗肌无力、抽动症、不安腿综合征的临床病案加以佐证。[结果]补肝汤之“补”义为补养肝血，方效养血滋阴、柔肝舒筋，临床常用于肝血不和、目失濡养，肝血亏损、筋骨不利，肝风内动、肢体震颤抽掣，血不养筋、不荣则痛，肝肾同源、久病入肾等症，舌脉特征多为舌质淡，脉弦细。熊继柏教授运用补肝汤组方严谨，明辨主症，稍加衍化；同时兼顾疾病传变，主次分明，善用合方。所选三则病案中，病案一为产后血虚，气血不荣则肌肉瘦削无力，治以补津养血、和血通痹；病案二中患者头部不自主抖动并伴有乏力、口苦，咽干等火热之证，此为肝血不足，阳浮风动，阳不敛阴以生内热，治以补肝养血、平肝熄风；病案三中患者右下肢不自主抖动，与情绪变化有密切关系，肝血不足，其疏泄功能欠佳，治以益气活血、温经通络。三则病案病机均为肝血不足、筋脉痹涩，故以补肝汤加减补肝血，治疗后均获良效。[结论]熊继柏教授运用补肝汤，从其涵养肝血的本义出发，再结合患者症状，随证论之，治疗肢体经络与情志不和等病症临床效果颇佳。 |
| 英文摘要: |
| [Objective] To explore the clinical experience of Professor XIONG Jibai， the master of traditional Chinese medicine， in the treatment of intractable diseases with Bugan Decoction， and seek its application rules in order to guide clinical treatment. [Methods] Through sorting out the medical records of Professor XIONG Jibai's clinical application of Bugan Decoction， consulting related literature， the common disease types， treatment methods and prescriptions laws were refined， and the clinical cases of using Bugan Decoction to treat myasthenia， tics， and restless legs syndrome were enumerated to support. [Results] Bugan Decoction means nourishing the liver blood， nourishing blood and nourishing Yin， softening the liver and soothing the muscles. It is often used clinically for disharmony of the liver and blood， eyes losing nutrition; loss of the liver blood， stiffness of muscle and joint; internal movement of the liver wind， tremor and convulsion of the limbs; blood failing to nourish the sinews， hurting without nutrition;the liver and kidney have common source， long-term disease affects the kidney. Tongue and pulse characteristics are mostly pale tongue and thin pulse string. Professor XIONG Jibai uses Bugan Decoction to make rigorous prescriptions， distinguish the main symptoms， and slightly derive them; at the same time， he takes into account the transmission of the disease， distinguishes the primary and secondary， and uses the prescription well. Among the three selected medical records， the first one was blood deficiency after childbirth， the blood was not prosperous leading to muscles weakness， and the treatment was to nourish body fluid and blood， and harmonize the blood to relieve paralysis. In the second case， the patient's head shook involuntarily accompanied by fatigue， bitter mouth， dry throat， that was deficiency of the liver blood， floating of Yang wind， Yang did not converge Yin leading to internal heat， and the treatment was to nourish the liver blood， calm the liver and expel the wind. In the third case， the patient's right lower limb trembled involuntarily， which was closely related to the emotional change， which was deficiency of the liver blood， and the liver function of dispersing was not good， and the treatment was to replenish Qi and activate blood circulation， warm channels and dredge meridian. Although the manifestations of the three medical records were different， the pathogen was all due to deficiency of the liver blood， astringent muscles and veins. Therefore， Bugan Decoction was added and subtracted to replenish the liver blood， and all the cases achieved good results. [Conclusion]Professor XIONG's usage of Bugan Decoction starts from its original meaning of nourishing the liver blood， modified with different clinical manifestations， and the clinical effect of treating limbs and meridian disorders and emotional discord is quite good. |
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