摘要
总结周仲瑛教授从虚实相因辨治肝炎肝硬化的临证经验.认为肝炎肝硬化病机总属本虚标实,以肝、脾、肾虚损为本,湿热瘀毒郁结为标,且虚实相因为患,主张治疗以清化邪实、补虚扶正为总则.肝炎肝硬化早期以邪实亢盛为主,治宜清化湿热瘀毒、兼顾调理脾胃,方选茵陈蒿汤合鳖甲煎丸加减.肝炎肝硬化中晚期多见虚实夹杂证,治宜清化湿热瘀毒、调补肝脾肾,常用清热祛湿、化瘀解毒之品治标,并根据本虚之肝脾不调、肝肾阴虚、肝脾肾俱虚三证,分别配伍六君子汤、一贯煎合二至丸、补中益气汤加减治疗.
Abstract
This paper summarized Professor ZHOU Zhongying's experience in differentiating and treating hepatitis and liver cirrhosis from deficiency and excess.It is considered that the pathogenesis of hepatitis and liver cirrhosis belongs to deficiency in root and excess in branch,with depletion of liver,spleen and kidney as the root,and con-straint and bind of damp-heat and stasis toxin as the branch.Moreover,mutual cause and promotion between deficiency and excess leads to the disease.For general principle of treatment,it is recommended to clear and transform pathogenic excess,supplement deficiency and rectify the healthy qi.In the early stage of hepatitis and cirrhosis,excess pathogen hyperactivity is the main manifestation,which can be treated by clearing and transforming damp-heat and stasis toxin,supplemented by regulating spleen and stomach,with modified Yinchenhao Decoction(茵陈蒿汤)and Biejiajian Pill(鳖甲煎丸).In the middle and late stages,cases with deficiency-excess complex were more common,which should be treated by clearing damp-heat and stasis toxin,regulating and supplementing liver-spleen-kidney,using medicinals with the function of clearing heat and dispelling damp,dissolving stasis and resolving toxins to treat the branch.Moreover,Liujunzi Decoction(六君子汤),Yiguan Decoction(一贯煎)plus Erzhi Pill(二至丸)and Buzhong Yiqi Decoction(补中益气汤)modifications are suggested respectively in correspondence to the different kinds of root defi-ciency including irregular liver and spleen,liver and kidney yin deficiency,and liver-spleen-kidney deficiency.
基金项目
中医科学院学部委员学术传承与传播专项(CI2022E028XB)
江苏省科技计划(BE2019723)
国家科技期刊平台
NSTL
万方数据