| 刘敏,刘喜德,周海丽,等.刘喜德教授中医药治疗痛风经验探析[J].浙江中医药大学学报,2021,45(10):1117-1120. |
| 刘喜德教授中医药治疗痛风经验探析 |
| Exploration of LIU Xide's Experience in the Treatment of Gout with Traditional Chinese Medicine |
| DOI：10.16466/j.issn1005-5509.2021.10.013 |
| 中文关键词: 痛风 三大矛盾 四妙散 医案 名医经验 刘喜德 |
| 英文关键词: gout three major contradictory problems Simiao Powder medical records famous doctor's experience LIU Xide |
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| 中文摘要: |
| [目的]阐述刘喜德教授中医药治疗痛风的用药经验及对辨治过程中三大矛盾问题的解决思路。[方法]通过跟师侍诊，研读刘喜德教授相关论文，总结中医药辨治痛风面临的主要矛盾，提出解决思路及凝练用药经验，并辅以医案一则佐证。[结果]刘师认为中医药治疗痛风面临三大矛盾:其一，病发急者应化毒止痛，但清化太过，则肿痛复发；其二，病趋缓者当利湿泄浊，但通利太过，则脾肾更伤；其三，病久及肾需益肾利湿，但补益太过，则闭门留寇。刘师四诊合参，辨证论治，立祛湿化浊、通络止痛基本大法，以四妙散(薏苡仁、苍术、黄柏、牛膝)为基础方，细审虚实之多少，病势之强弱，邪气之盛衰，加减变通，卓有成效。所举验案为痛风典型病例，三大矛盾问题贯穿治疗始终，处方以四妙散为基础方，根据不同时期病情矛盾特点化裁运用，辨证论治，疗效显著。[结论]刘喜德教授辨治痛风根据分期不同，抓住主要矛盾，立四妙散为基础方，注重虚实邪盛，其经验特色鲜明，值得借鉴。 |
| 英文摘要: |
| [Objective] To introduce Professor LIU Xide's experience of medication in the treatment of gout with traditional Chinese medicine(TCM) and ideas for solving the three major contradictory problems in the process of differentiation and treatment. [Methods] Through following the teacher's clinical work and studying the related papers， it summarized the main contradiction of TCM in syndrome differentiation and treatment of gout， put forward the solution ideas and condensed the medication experience， and one clinical case was presented as proof. [Results] Professor LIU thinks that there are three major contradictions in the clinical management of gout: First， the patient in emergency should be treated with detoxification and pain relief， but excessive clearance of heat toxins will cause swelling and pain recurrence; secondly， the patient in remission duration should be treated with eliminating dampness and resolving turbidity， while excessive diuresis leads to greater damage to the spleen and kidney; at last， the disease will involve the kidney when the disease lasts for a long time， the treatment needs to invigorate the kidney and diuresis， but over complement will lead to the risk of bandits staying behind closed doors. In clinical practice， Professor LIU takes the methods of dispelling dampness and resolving turbidity， dredging collateral and relieving pain as basic treating methods based on combination of the four diagnostic methods and syndrome differentiation， establishes Simiao Powder(Semen Coicis， Atractylodis Rhizoma， Cortex Phellodendri Chinensis， Achyranthes bidentata) as the foundation prescription， and carefully examines the amount of deficiency and excess， the strength of illness， and the rise and fall of pathogen， the treatment of addition and subtraction is very flexible and effective. The attached medical case was a typical case of gout， and the three contradictions ran through the treatment. The prescription was based on Simiao Powder， which was used according to the characteristics of disease contradictions in different periods， and the curative effect was remarkable. [Conclusion] According to different stages of gout， Professor LIU grasps the major contradictory in syndrome differentiation and treatment， establishes Simiao Powder as the foundation prescription and pays attention to excess and deficiency. His experience is distinctive and worthy of clinical reference. |
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