| 张芸旗,洪靖,王恒坤,等.张杰教授辨治泄泻经验及验案举隅[J].浙江中医药大学学报,2021,45(6):625-628, 632. |
| 张杰教授辨治泄泻经验及验案举隅 |
| Differentiation and Treatment Experience on Diarrhea and Proved Cases by Professor |
| DOI：10.16466/j.issn1005-5509.2021.06.010 |
| 中文关键词: 泄泻 脾虚 湿盛 脾阳为本 肝脾建中 张杰 名医经验 验案 |
| 英文关键词: diarrhea the deficiency of the spleen overabund ance of dampness attaching importance to spleen Yang the liver and spleen construction for the middle-Jiao ZHANG Jie experience of famous doctor medical cases |
| 基金项目:国家中医药管理局全国名老中医药专家张杰传承工作室建设项目(国中医药人教发[2012]149号) |
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| 中文摘要: |
| [目的]总结国家级名老中医张杰教授辨治泄泻的经验。[方法]通过跟随张杰教授门诊，整理分析医案，查阅相关古籍和文献，从病因病机和辨治经验两方面对张杰教授治疗泄泻的学术思想及临床思路进行分析总结，并附典型验案两则加以佐证。[结果]张杰教授认为脾虚湿盛为泄泻的关键病机，脾虚以脾阳虚为要，湿有寒热之别，并独创“脾阳为本”和“肝脾建中”理论指导临床，主张脾阳为本、兼顾肾阳，亦重视肝脾建中、身心并治，同时以寒热平调、中焦自衡为度，并且自拟验方建中化湿汤，药用专长。所附验案一为脾肾阳虚、寒湿困中证，治宜温脾暖肾、散寒化湿、涩肠止泻，方以理中丸合四神丸加味；验案二为肝脾失调、湿热中阻证，治宜调和肝脾、化湿清热，方以半夏泻心汤合痛泻要方加味，均取得显著疗效。[结论]张杰教授辨治泄泻，紧扣病机，重视“脾阳为本”和“肝脾建中”理论，并结合四诊，整体辨证论治，疗效显著，其经验值得临床学习和借鉴。 |
| 英文摘要: |
| [Objective] To summarize the experience of national traditional Chinese medicine(TCM) expert Professor ZHANG Jie in the treatment of diarrhea.[Methods]By following Professor ZHANG Jie's outpatient department，sorting out and analyzing medical cases and consulting relevant ancient books and literatures，this paper analyzed and summarized Professor ZHANG Jie's academic thoughts and clinical ideas on diarrhea treatment from two aspects of etiology and pathogenesis and treatment experience，and two typical cases were presented as proof.[Results] Professor ZHANG considers that the deficiency of the spleen with overabundance of dampness is the key pathogenesis， the deficiency of the spleen Yang is the main deficiency， and there is a difference between heat and cold in dampness. Professor ZHANG advocates the principle of “attaching importance to spleen Yang” and “the liver and spleen construction for the middle-Jiao” to guide clinical practice. He advocates attaching importance to the spleen Yang， giving consideration to the kidney Yang， also pays attention to harmonizing the liver and spleen， curing body and mind together， regards reconciling cold and heat to keep middle-Jiao balance as measurement， Professor ZHANG creates Jianzhong Huashi decoction and uses special herbs. Case one was identified as deficiency of the spleen and kidney Yang， cold-dampness trapped in middle-Jiao， and the patient was treated with modified Lizhong pill and Sishen pill on the rule of warming the spleen and kidney， dissipating cold and resolving dampness， relieving diarrhea with astringents. Case two was identified as disorder between the liver and spleen， dampness-heat trapped in middle-Jiao， and the patient was treated with modified Banxia Xiexin decoction and Tongxieyao formula on the rule of harmonizing the liver and spleen， and eliminating dampness and clearing away heat. Both of them achieved obvious therapeutic effects.[Conclusion] Professor ZHANG Jie treats diarrhea by means of closely focusing on pathogenesis， emphasizing the principle of “attaching importance to spleen Yang” and “the liver and spleen construction for the middle-Jiao”， combining with four diagnostic informations of patients in TCM， treatment based on syndrome differentiation from the whole， the curative effect is significant， his experience is worthy of clinical learning. |
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