| 吴山,宋子瑜,李力,等.范永升教授从伏邪温病论治全身型幼年特发性关节炎学术经验探析[J].浙江中医药大学学报,2024,48(3):307-311. |
| 范永升教授从伏邪温病论治全身型幼年特发性关节炎学术经验探析 |
| Professor FAN Yongsheng’s Academic Experience in Treating Systemic Juvenile Idiopatic Arthritis from the Latent Pathogens Warm Disease |
| DOI：10.16466/j.issn1005-5509.2024.03.009 |
| 中文关键词: 全身型幼年特发性关节炎 伏邪温病 火郁发之 医案 名医经验 范永升 |
| 英文关键词: systemic juvenile idiopathic arthritis latent pathogens warm disease fire stagnation requiring dissipation medical cases experience of famous doctor FAN Yongsheng |
| 基金项目:浙江省自然科学基金项目(LQ23H270015)；科技部国家重点研发计划项目子课题(2018YFC1704102)；浙江省中医药科技计划项目(2020ZB106)；浙江省中青年临床名中医培养项目(浙中医药〔2022〕7号) |
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| 中文摘要: |
| [目的] 总结首届全国名中医范永升教授治疗全身型幼年特发性关节炎的学术经验。[方法] 通过跟诊学习，整理分析典型病案，并参阅相关文献，结合范永升教授的著作及临证所述，从病因病机、治疗思路两个层面总结归纳范永升教授治疗全身型幼年特发性关节炎的学术经验，并附验案一则加以佐证。[结果] 范永升教授认为，全身型幼年特发性关节炎发病过程与温病卫气营血转变规律相似，致病特点与伏邪温病也有相似之处，多因正气亏虚于内，加之感受外邪，伏藏于里，伺机而发，或外邪引动而发。临床应用火郁发之，透解伏邪；顾护正气，攻伐有度；续贯治疗，增效减毒等治疗思路治疗本病，取得了满意的临床疗效。验案中患者就诊初期表现为邪伏阴分、气营两燔，治以清解和营、祛风通络；药后疹消热退，伏邪出阳，枢机不利，治以和解枢机、清透郁热；待邪气渐去，正气已衰，遂予以疏解透热，佐以和胃健脾。整个治疗过程中辛透伏邪贯穿始终，同时体现了范永升教授用药灵活、顾护正气的治疗思路。[结论] 范永升教授以伏邪温病理论为基础，从卫气营血辨治全身型幼年特发性关节炎临床收效甚佳，其学术经验值得借鉴和推广。 |
| 英文摘要: |
| [Objective] To review and summarize the academic experience of Professor FAN Yongsheng， one of the first session national famous traditional Chinese medicine masters， in the treatment of systemic juvenile idiopathic arthritis. [Methods] Through follow-up study， sorting out and analyzing typical medical records， and referring to relevant literature， combined with Professor FAN Yongsheng’s works and clinical practice， Professor FAN Yongsheng’s academic experience in the treatment of systemic juvenile idiopathic arthritis was summarized from two aspects of etiology， pathogenesis and treatment ideas， and one proven case was attached for evidence. [Results] Professor FAN Yongsheng believes that the pathogenic process of systemic juvenile idiopathic arthritis conforms to the law of the transformation of warm diseases Wei Qi Ying Xue， which is similar to the pathogenic characteristics of latent pathogenic febrile diseases. It is mostly caused by the deficiency of healthy Qi in the interior， combined with the invasion of external pathogens， hidden in the interior， waiting for opportunities， or triggered by external pathogens. Clinical application of fire stagnation requires dissipation， dispersing and expelling the latent pathogens; protecting the healthy Qi， moderating exorcism; sequential therapy， toxicity reduction and efficacy enhancement and other treatment ideas have achieved satisfactory clinical results in the treatment of this disease. In the test case， the initial manifestation of the patient was the pathogen lurking in Yin phase， dual blaze of Qi and Ying， and the treatment was to clear heat toxin and harmonize Ying， dispel wind and dredge collaterals; after treatment， rash regression and fever relieve， latent pathogens were affected from Yin to Yang and cardinal dysfunction， and the treatment was to reconcile cardinal， clear and expel the stagnant heat; when the pathogenic Qi disappeared gradually， the healthy Qi declined， the treatment was given to disperse and expel the heat， combined with invigorating the spleen and harmonizing the stomach. The whole process of treatment was permeated throughout dispersing latent pathogens， and at the same time reflecting Professor FAN Yongsheng’s treatment ideas of flexible drug use， taking care of healthy Qi. [Conclusion] Professor FAN Yongsheng has achieved good clinical results in the treatment of systemic juvenile idiopathic arthritis based on the theory of latent pathogenic warm disease， and his academic experience is worthy of reference and promotion. |
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