周平安从内风论治贲门失弛缓症经验
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摘要
总结周平安诊治贲门失弛缓症经验。认为贲门失弛缓症属于中医学"噎膈"范畴,其发病的根源在于贲门括约肌紧张,应从内风论治。本病病位在脾胃,与肝密切相关,阴血不足、肝阳偏亢是产生内风的关键,熄风解痉应当贯穿治疗始终,同时辨证使用化痰降气和行气化瘀通络之法,肝阳偏亢化风者,常用天麻钩藤饮加减;而对于因虚致实、风痰阻络者,可予以地龙、全蝎、蜈蚣等虫类药增强熄风化痰通络之功。
This paper summarized the experience Professor ZHOU Ping'an in treating achalasia. ZHOU believes that achalasia belongs to the "dysphagia"in traditional Chinese medicine(TCM),and the root cause lies in the tension of the cardiac sphincter,which should be treated with the "endogenous wind"theory. The disease is located in the spleen and stomach,and is closely related to the liver. Then deficiency of yin and blood and hyperactivity of liver yang are the key to the occurrence of endogenous wind. Thus relieving spasm by calming endogenous wind should be consistent throughout the process of treatment. The methods of dissipating phlegm and descending qi,and activating qi flowing,dissipate blood stasis and removing obstruction in collaterals should be applied with syndrome differentiation. For the patients with hyperactivity of liver yang leading to endogenous wind,modified Tianma Gouteng Decoction was frequently used. For those with excess syndrome resulted from deficiency and wind-phlegm blocking collaterals,the medicinal insects such as Lumbricus,Scorpio,Scolopendra are used to enhance the function of eliminating the wind,reducing phlegm and expelling stagnation.
This paper summarized the experience Professor ZHOU Ping'an in treating achalasia. ZHOU believes that achalasia belongs to the "dysphagia"in traditional Chinese medicine(TCM),and the root cause lies in the tension of the cardiac sphincter,which should be treated with the "endogenous wind"theory. The disease is located in the spleen and stomach,and is closely related to the liver. Then deficiency of yin and blood and hyperactivity of liver yang are the key to the occurrence of endogenous wind. Thus relieving spasm by calming endogenous wind should be consistent throughout the process of treatment. The methods of dissipating phlegm and descending qi,and activating qi flowing,dissipate blood stasis and removing obstruction in collaterals should be applied with syndrome differentiation. For the patients with hyperactivity of liver yang leading to endogenous wind,modified Tianma Gouteng Decoction was frequently used. For those with excess syndrome resulted from deficiency and wind-phlegm blocking collaterals,the medicinal insects such as Lumbricus,Scorpio,Scolopendra are used to enhance the function of eliminating the wind,reducing phlegm and expelling stagnation.
引文
[1]徐晓玥,李全林,周平红.贲门失弛缓症病因研究进展[J].中华消化内镜杂志,2016,33(2):127-130.
[2]代忠明,聂占国.贲门失弛缓症发病机理及诊治进展综述[J].新疆医学,2017,47(10):1101-1102.
[3]印会河.中医基础理论[M].上海:上海科学技术出版社,1991:115.
[4]张晓阳.论风病(症)的临床特征[J].北京中医药大学学报,2001,24(6):73-74.
[5]孙斌,刘德地,王亚雷,等.不同亚型贲门失弛缓症的食管动力学特点的研究[J].安徽医科大学学报,2018,53(1):151-154.
[6]朱广伟,张贵君,汪萌,等.中药芍药甘草汤基原及药效组分和药理作用研究概况[J].中华中医药杂志,2015,30(8):2865-2869.
[7]唐鼎,凃乾,李娟,等.药用地龙的药理作用和临床研究进展[J].中国药师,2015,18(6):1016-1019.
[8]张乔,刘东,赵子佳,等.蜈蚣有效成分提取分离及药理作用研究[J].吉林中医药,2017,37(3):263-265.
[2]代忠明,聂占国.贲门失弛缓症发病机理及诊治进展综述[J].新疆医学,2017,47(10):1101-1102.
[3]印会河.中医基础理论[M].上海:上海科学技术出版社,1991:115.
[4]张晓阳.论风病(症)的临床特征[J].北京中医药大学学报,2001,24(6):73-74.
[5]孙斌,刘德地,王亚雷,等.不同亚型贲门失弛缓症的食管动力学特点的研究[J].安徽医科大学学报,2018,53(1):151-154.
[6]朱广伟,张贵君,汪萌,等.中药芍药甘草汤基原及药效组分和药理作用研究概况[J].中华中医药杂志,2015,30(8):2865-2869.
[7]唐鼎,凃乾,李娟,等.药用地龙的药理作用和临床研究进展[J].中国药师,2015,18(6):1016-1019.
[8]张乔,刘东,赵子佳,等.蜈蚣有效成分提取分离及药理作用研究[J].吉林中医药,2017,37(3):263-265.
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