| 李云强,陈冬雪,黎明全.黎明全应用柴胡加龙骨牡蛎汤治疗脑病经验辑要[J].浙江中医药大学学报,2023,47(2):219-221, 226. |
| 黎明全应用柴胡加龙骨牡蛎汤治疗脑病经验辑要 |
| Summary of LI Mingquan‘s Experience in the Treatment of Encephalopathy with Chaihu Plus Longgu Muli Decoction |
| DOI：10.16466/j.issn1005-5509.2023.02.020 |
| 中文关键词: 柴胡加龙骨牡蛎汤 经典名方 方证相应 脑病 重镇安神 经验 |
| 英文关键词: Chaihu Plus Longgu Muli Decoction classic famous formula the correspondence of formula and syndrome cerebral diseases tranquilization with heavy drugs experience |
| 基金项目:吉林省科技发展计划项目(20200404065YY) |
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| 中文摘要: |
| [目的] 探析黎明全教授应用柴胡加龙骨牡蛎汤治疗脑病的临床经验和学术观点，为临证选方提供借鉴。[方法] 选取黎师治疗的失眠、帕金森病伴抑郁、特发性震颤验案3则，结合平时侍诊的心得体会详加按评，从辨别患者体质和四纲辨证角度出发，探索黎师诊治脑病的特色和经验。[结果] 柴胡加龙骨牡蛎汤为临床常用的经典名方，具有和解少阳、通阳泄热、重镇安神的功效。黎师提出，应用柴胡加龙骨牡蛎汤治疗脑病时首先辨识出柴胡体质属实证、热证的患者，然后根据患者的证候要素遣方用药，本方证多指“胸满烦惊，小便不利，谵语，一身尽重，不可转侧”，治疗具体疾病时再结合患者的证型辨证论治。所举失眠案乃痰热腑实、火扰心神之证，拟泻热通腑、和中安神为基本治法；所举帕金森病伴抑郁案为肝郁化火、痰热扰心之证，治以疏肝解郁、清热化痰法；所举特发性震颤验案为痰热动风、火扰清窍之证，治以清湿祛热、平肝熄风法，应用柴胡加龙骨牡蛎汤加减治疗后，均获得较好疗效。[结论] 黎师应用柴胡加龙骨牡蛎汤治疗脑病注重“方证相应”，临床效果显著，其经验值得学习和借鉴。本方亦可以作为脑病的专用方，临床诊疾时可辨证与辨病相结合，提高临床疗效。通过复习验案，有助于读者了解准确应用柴胡加龙骨牡蛎汤的辨证要点，体会异病同治的精妙。 |
| 英文摘要: |
| [Objective] To explore Professor LI Mingquan‘s clinical experience and academic views on the application of Chaihu Plus Longgu Muli Decoction in the treatment of encephalopathy in order to provide reference for the selection of clinical evidence. [Methods] Selecting three cases of Professor LI including insomnia， Parkinson‘s disease with depression， and idiopathic tremor， combined with the experience of the usual clinic and detailed comments， the characteristics and experience of diagnosing and treating encephalopathy were explored from the perspective of identifying patients‘ constitution and four-class syndrome differentiation. [Results] Chaihu Plus Longgu Muli Decoction is a classical formula commonly used in clinical practice， which has the effects of resolving Shaoyang， promoting Yang circulation and relieving heat， and calming the mind. Professor LI proposes that when using Chaihu Plus Longgu Muli Decoction to treat encephalopathy， the first step is to identify patients with actual or heat symptoms， then according to the elements of the patient‘s symptoms， the formula is used， and the syndicme mostly refers to “chest fullness， irritability， urinary inconvenience， delirium， all-over heaviness， and inability to turn the side”， and the treatment of specific diseases should combine with the patient‘s type of syndicme. The case of insomnia cited was syndrome of phlegm-heat accumulation in viscera and fire disturbing the heart and mind， the basic treatment was to purge away heat and clear the viscera， harmonize the middle-Jiao and calm the mind； the case of Parkinson‘s disease with depression was syndrome of liver depression transforming into fire and phlegm-heat disturbing the heart， the treatment was to dredge the liver and relieve depression， clear heat and reduce phlegm； the case of idiopathic tremor was syndrome of phlegm-heat moving wind and fire disturbing the clear orifices， the treatment was to clear dampness and dispel heat， calm the liver and quench the wind. After treated wiht modified Chaihu Plus Longgu Muli Decoction， all of the patients above achieved good results. [Conclusion] When applying Chaihu Plus Longgu Muli Decoction in the treatment of encephalopathy， Professor LI pays attention to the “correspondence between formula and syndicme”， and the clinical results are remarkable， and this experience is worth learning from. The formula can be used as a special formula for encephalopathy and can be used to improve clinical efficacy by combining the identification of syndicme and disease during clinical diagnosis. By reviewing clinical cases， it is helpful for readers to understand the key points of accurate application of Chaihu Plus Longgu Muli Decoction and appreciate the subtlety of treating different diseases together. |
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