李敬林治疗消渴并头痛
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摘要
李敬林教授对于消渴并头痛的病因病机、辨证分型及治法用药均有独到见解。李老提出从肝论治消渴并头痛,认为此病多由情志不遂、肝气不舒引发,因肝失疏泄,郁而化火致上实,火盛伤阴,肝失濡养,致肾水不足而下虚,故病机多以"上实下虚"为主。临证时,李老根据疼痛部位、性质及持续时间结合全身症状进行辨证论治,将"清上导下调肝"作为治疗之大法,以《止园医话》中提取的头痛要方作为基础方,巧用药对及引经药,并善用轻清之剂,灵活化裁,临床疗效显著。
Professor Li Jinglin has unique views on the etiology, pathogenesis, syndrome differentiation and treatment of consumptive thirst with headache(diabetes with hypertension). He prefers to treat the disease from liver and holds that emotional frustration, dissatisfaction and liver abnormal dispersion are the main causes of the disease. Due to liver controlling conveyance and dispersion, qi depression transforming into fire, there is a syndrome of upper excess. Owing to blazing fire injuring yin, malnutrition of liver and insufficiency of kidney yin, there is a syndrome of upper excess. Therefore, the main pathogenesis of this disease is "upper excess and lower deficiency". According to the location, nature and duration of pain combined with systemic symptoms, Professor Li takes "clearing the upper part and dredging the lower by regulating liver" as the treatment method, and the headache prescription extracted in Zhiyuan Yihua as the basic prescription. He uses pair drugs and channel ushering drugs skillfully and makes good use of light prescriptions flexibly, with remarkable clinical effect.
Professor Li Jinglin has unique views on the etiology, pathogenesis, syndrome differentiation and treatment of consumptive thirst with headache(diabetes with hypertension). He prefers to treat the disease from liver and holds that emotional frustration, dissatisfaction and liver abnormal dispersion are the main causes of the disease. Due to liver controlling conveyance and dispersion, qi depression transforming into fire, there is a syndrome of upper excess. Owing to blazing fire injuring yin, malnutrition of liver and insufficiency of kidney yin, there is a syndrome of upper excess. Therefore, the main pathogenesis of this disease is "upper excess and lower deficiency". According to the location, nature and duration of pain combined with systemic symptoms, Professor Li takes "clearing the upper part and dredging the lower by regulating liver" as the treatment method, and the headache prescription extracted in Zhiyuan Yihua as the basic prescription. He uses pair drugs and channel ushering drugs skillfully and makes good use of light prescriptions flexibly, with remarkable clinical effect.
引文
[1]郑南,高丽娟,唐仁康,等.古代医籍对消渴病的认识[J].吉林中医药, 2015, 35(5):530-533.
[2]王煜.王自立主任医师柔肝思想探悉[J].西部中医药,2014, 27(4):24-25.
[3]张震,乔明琦,高冬梅.肝主疏泄调畅情志的发病机制探究[J].西部中医药, 2015, 28(4):48-50.
[4]于峥,黄晓华,滕静如,等.肝主疏泄畅情志的理论内涵及临床应用[J].中医杂志, 2013, 54(22):1914-1916.
[5]葛帅,孙丽霞.“肝为贼脏”浅析[J].临床肝胆病杂志,2016, 32(4):790-792.
[6]蒋军林,周慎.顽固性头痛从肝血虚论治[J].世界中西医结合杂志, 2015, 10(5):700-702.
[7]俞悦,过伟峰.从肝论治紧张型头痛[J].吉林中医药,2015, 35(4):337-339.
[8]陈敏,黄宁静,王祎晟.泻火止痛方治疗肝火上炎型偏头痛的临床研究[J].中西医结合心脑血管病杂志, 2015,13(12):1375-1377.
[9]常福业.头痛从肝论治十一法[J].山东中医杂志, 2003,22(10):601-603.
[10]毕艳平,赵晶晶,王静,等.半夏白术天麻汤加减治疗痰湿型经行头痛临床研究[J].亚太传统医药, 2015, 11(20):93-95.
[11]高玲,赵建军.赵建军教授治疗偏头痛经验[J].长春中医药大学学报, 2017, 33(6):909-911.
[12]李昭坤.李敬林教授运用清上导下法治疗肝阳头痛经验总结[D].沈阳:辽宁中医药大学, 2013:1.
[13]张春兰,吕光耀,刘秋燕.治疗头痛引经药的源流及临床应用[J].中医杂志, 2013, 54(16):1374-1376.
[14]滕飞,石岩.历代医家论头痛学术思想探析[J].长春中医药大学学报, 2016, 32(1):5-8.
[15]宫成军.李敬林教授治疗头痛学术经验总结[J].辽宁中医杂志, 2016, 43(12):2500-2502.
[16]曾宪娜,曾永青.中药引经药溯本追源之探究[J].内蒙古中医药, 2015, 34(8):148-150.
[17]郑一,高玉红.头痛引经药物理论研究及方法论探讨[J].北京中医药大学学报, 2003, 26(4):10-13.
[18]吴大龙,赵德喜,赵婧彤,等.引经药在偏头痛中的应用[J].长春中医药大学学报, 2016, 32(5):953-955.
[19]吴娟,谢晋,张群林,等.中药引经理论的现代研究进展和思路[J].中国中药杂志, 2016, 41(13):2428-2434.
[20]杨琳,张丽萍.浅论“火郁发之”[J].浙江中医药大学学报,2015, 39(10):727-729.
[2]王煜.王自立主任医师柔肝思想探悉[J].西部中医药,2014, 27(4):24-25.
[3]张震,乔明琦,高冬梅.肝主疏泄调畅情志的发病机制探究[J].西部中医药, 2015, 28(4):48-50.
[4]于峥,黄晓华,滕静如,等.肝主疏泄畅情志的理论内涵及临床应用[J].中医杂志, 2013, 54(22):1914-1916.
[5]葛帅,孙丽霞.“肝为贼脏”浅析[J].临床肝胆病杂志,2016, 32(4):790-792.
[6]蒋军林,周慎.顽固性头痛从肝血虚论治[J].世界中西医结合杂志, 2015, 10(5):700-702.
[7]俞悦,过伟峰.从肝论治紧张型头痛[J].吉林中医药,2015, 35(4):337-339.
[8]陈敏,黄宁静,王祎晟.泻火止痛方治疗肝火上炎型偏头痛的临床研究[J].中西医结合心脑血管病杂志, 2015,13(12):1375-1377.
[9]常福业.头痛从肝论治十一法[J].山东中医杂志, 2003,22(10):601-603.
[10]毕艳平,赵晶晶,王静,等.半夏白术天麻汤加减治疗痰湿型经行头痛临床研究[J].亚太传统医药, 2015, 11(20):93-95.
[11]高玲,赵建军.赵建军教授治疗偏头痛经验[J].长春中医药大学学报, 2017, 33(6):909-911.
[12]李昭坤.李敬林教授运用清上导下法治疗肝阳头痛经验总结[D].沈阳:辽宁中医药大学, 2013:1.
[13]张春兰,吕光耀,刘秋燕.治疗头痛引经药的源流及临床应用[J].中医杂志, 2013, 54(16):1374-1376.
[14]滕飞,石岩.历代医家论头痛学术思想探析[J].长春中医药大学学报, 2016, 32(1):5-8.
[15]宫成军.李敬林教授治疗头痛学术经验总结[J].辽宁中医杂志, 2016, 43(12):2500-2502.
[16]曾宪娜,曾永青.中药引经药溯本追源之探究[J].内蒙古中医药, 2015, 34(8):148-150.
[17]郑一,高玉红.头痛引经药物理论研究及方法论探讨[J].北京中医药大学学报, 2003, 26(4):10-13.
[18]吴大龙,赵德喜,赵婧彤,等.引经药在偏头痛中的应用[J].长春中医药大学学报, 2016, 32(5):953-955.
[19]吴娟,谢晋,张群林,等.中药引经理论的现代研究进展和思路[J].中国中药杂志, 2016, 41(13):2428-2434.
[20]杨琳,张丽萍.浅论“火郁发之”[J].浙江中医药大学学报,2015, 39(10):727-729.
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