| 杨昊偌,周捷,孙鑫,等.国医大师周仲瑛从痰瘀热结辨治系统性硬化症经验撷要[J].浙江中医药大学学报,2024,48(1):41-45. |
| 国医大师周仲瑛从痰瘀热结辨治系统性硬化症经验撷要 |
| Experience of Traditional Chinese Medicine Master ZHOU Zhongying in Treating Systemic Sclerosis from the Pathogenesis of Phlegm-Stasis-Heat Junction |
| DOI：10.16466/j.issn1005-5509.2024.01.006 |
| 中文关键词: 系统性硬化症 痰瘀热结 复合病机 审证求机 名医经验 周仲瑛 |
| 英文关键词: systemic sclerosis phlegm-stasis-heat junction complex pathogenesis identifying the root of disease for pathogenesis experience of famous doctors ZHOU Zhongying |
| 基金项目:国家中医药管理局国医大师周仲瑛传承工作室建设项目(国中医药人教发〔2010〕59号)；江苏省社会发展重点研发计划项目(BE2019723) |
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| 中文摘要: |
| [目的] 总结国医大师周仲瑛从痰瘀热结复合病机治疗系统性硬化症的临证经验，为临床提供参考。[方法] 通过临床学习、收集整理周老治疗系统性硬化症的医案，从病因病机、辨机论治、用药特色等方面阐述周老治疗该病的临床经验，并举医案一则加以佐证。[结果] 周老认为，系统性硬化症的病机关键为痰瘀热结，病理因素以“痰、瘀、热”为主导，三者转化相兼，复合为患，贯穿病程始终；根据病情进展及病理因素的演变，治疗多从痰瘀热结复合病机入手。痰瘀内生，胶结为患，治宜化痰祛瘀、逐邪蠲痹；痰热蕴结，热扰则发，治宜清化痰热、宣痹散结；瘀热相搏，血热鸱张，治宜凉血散瘀、寓透于清；伤阴耗气，虚热内生，治宜益气养阴、扶正祛邪。文中所附验案，周老辨为痰瘀热结、风湿痹阻、气阴两伤证，治以化痰祛瘀、透热蠲痹、益气养阴，方用白薇煎合秦艽鳖甲散加减。[结论] 国医大师周仲瑛倡导辨证宜首重病机，从痰瘀热结复合病机辨治系统性硬化症，复法合治，灵活遣方，疗效显著，其经验值得传承推广。 |
| 英文摘要: |
| [Objective] To study and summarize the experience of traditional Chinese medicine Master ZHOU Zhongying in treating systemic sclerosis from the pathogenesis of phlegm-stasis-heat junction， providing references for clinical practice. [Methods] Through the clinical learning， collation and analysis of Professor ZHOU’s medical cases in the treatment of systemic sclerosis， the paper elaborated his clinical thinking and experience in the treatment of systemic sclerosis， which included etiology， pathogenesis， therapy and characteristic clinical medication， and verified it with medical records. [Results] Professor ZHOU thinks the key pathogenesis is phlegm-stasis-heat junction， pathological factors of systemic sclerosis mainly include phlegm， blood stasis and heat， which can depend on each other mutually throughout the course of disease. According to the progression of the disease and the evolution of pathological factors， treatment is primarily focused on phlegm-stasis-heat junction. Phlegm and blood stasis are interrelated， obstructing the circulation of Qi-blood so as to lead to pain and swelling， the treatment should be resolving phlegm， removing blood stasis and activating meridians; phlegm and heat are lingered each other， exacerbating the progression of the condition， it is appropriate to clear away phlegm and heat so that symptoms of skin redness and swelling can be relieved; blood and heat are interweaved together， which invade the skin and joints seriously， it is advisable to expel pathogenic factors by clearing away heat and resolving blood stagnation; Yin is damaged and Qi is consumed terribly， subsequently deficiency-heat is gradually emerging， the way to solve it is to supplement Qi， nourish Yin and strengthen the body resistance to eliminate pathogenic factors. The case was diagnosed as accumulation of phlegm stasis heat， blockage of wind-dampness and deficiency of Qi and Yin by Professor ZHOU， and treated with dissipating phlegm and removing blood stasis， clearing heat and unblocking collaterals， supplementing Qi and nourishing Yin， and the recipe Baiwei Decoction combined with Qinjiao Biejia Powder modified was used. [Conclusion] ZHOU Zhongying， the traditional Chinese medicine Master， who advocates attaching importance to the pathogenesis firstly in the process of syndrome differentiation， treating systemic sclerosis from the pathogenesis of phlegm-stasis-heat junction， which plays a unique role in relief of clinical symptoms， and his experiences are worthy of inheritance and promotion. |
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