王琦教授应用“辨体-辨病-辨证”诊疗模式治疗偏头痛经验
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摘要
在临床诊治疾病过程中,由于疾病的复杂性,单一诊疗模式的局限性,王琦教授将辨体、辨病、辨证相结合,建立了"辨体-辨病-辨证诊疗模式"(即"三辨模式"),辨体-辨病-辨证相结合的诊疗思想,对于诊治疑难病、反复发作性疾病,疗效能明显提高。偏头痛为反复发作的一种难治性疾病,体质不同可影响偏头痛的发病、病程及预后,偏头痛患者与中医体质存在一定的关系。偏头痛患者的体质类型分布具有一定的聚集性,且偏头痛患者的中医体质也具有一定的偏颇体质易感性。王琦教授根据诊疗偏头痛的经验,将偏头痛体质进行分类,并进一步辨证,从总体上把握患者疾病的整体状态,有利于对疾病本质的揭示,疗效明显得到提高,此法对临床诊治疾病具有重要的意义,应该进一步推广应用。
During the process of clinical diagnosis and treatment of disease,due to the complexity of the disease and the limitations of the single diagnosis and treatment model,Professor Wang Qi combined the differentiation-disease,differentiation-syndrome,differentiation method and established Trinity of physique differentiation,diagnosis of disease and syndrome differentiation. The efficacy could significantly improved when we applying constitution differentiation-disease differentiation-syndrome differentiation method to treat difficult and recurrent diseases. Migraine was a refractory disease with recurrent attacks. Different physique could affect the attack,course and prognosis of migraine. There was a certain relationship between migraine patients and TCM body constitution. The distribution of constitutional types of migraine patients had a certain degree of aggregation,and the TCM constitution of migraine patients also had a certain biased physical susceptibility. Professor Wang Qi classified the constitution of migraine according to the experience of diagnosis and treatment of migraine,and further differentiates Syndrome,and obtain the whole state of patient. This method was beneficial to reveal the nature of diseases and improve the curative effect. It was of great realistic significance in clinical diagnosis and treatment diseases,and should be further promoted and applied.
During the process of clinical diagnosis and treatment of disease,due to the complexity of the disease and the limitations of the single diagnosis and treatment model,Professor Wang Qi combined the differentiation-disease,differentiation-syndrome,differentiation method and established Trinity of physique differentiation,diagnosis of disease and syndrome differentiation. The efficacy could significantly improved when we applying constitution differentiation-disease differentiation-syndrome differentiation method to treat difficult and recurrent diseases. Migraine was a refractory disease with recurrent attacks. Different physique could affect the attack,course and prognosis of migraine. There was a certain relationship between migraine patients and TCM body constitution. The distribution of constitutional types of migraine patients had a certain degree of aggregation,and the TCM constitution of migraine patients also had a certain biased physical susceptibility. Professor Wang Qi classified the constitution of migraine according to the experience of diagnosis and treatment of migraine,and further differentiates Syndrome,and obtain the whole state of patient. This method was beneficial to reveal the nature of diseases and improve the curative effect. It was of great realistic significance in clinical diagnosis and treatment diseases,and should be further promoted and applied.
引文
[1]王琦,骆斌.辨体-辨病-辨证诊疗模式创建与应用[M].北京:中国中医药出版社:2015:132,158-160.
[2]王睿林.中医体质学的发展与中西医结合[J].天津中医药,2005,22(1):53-55.
[3]Vaughn WT. Allergic migraine[J]. JAMA,1927,88(18):1383-1386.
[4]Unger AH,Unger L. Migraine is an allergic disease[J]. J Allergy,1952,23(5):429-440.
[5]游思惟.作为过敏性疾患的偏头痛临床表现[J].国外医学·神经病学神经外科学分册,1980,5(6):617.
[6]赵英贤,张巧俊,孙秀珍,等.偏头痛的食物变态反应[J].陕西医学杂志,1993,22(11):649-650.
[7]李来刚,韩金安,王昌铭.季节性偏头痛患者过敏原试验与Ig E检测结果分析[J].华北国防医药,2010,22(1):29-30.
[8]许梦雪,曹文英,吴瑾.偏头痛与过敏症的相关性研究进展[J].中国疼痛医学杂志,2018,24(11):851-854.
[9]杨菲,张惠敏,陈雪梅,等.浅谈国医大师王琦教授从调理过敏体质角度治疗偏头痛的思路[J].世界中医药,2015,10(10):1900-1902.
[10]黎婉玲.偏头痛患者的中医体质特征研究[D].广州:南方医科大学,2012.
[11]李柱. 300例偏头痛患者中医体质分布及与中医证候关系临床研究[J].辽宁中医药大学学报,2015(10):13-14.
[12]赵艳敏.女性偏头痛缓解期中医证候及体质分布规律的临床研究[D].郑州:河南中医学院,2015.
[13]栾旭慧.运用体质辨识理论开展偏头痛间歇期辩证施护的构想[J].中医临床研究,2012,4(19):107-109.
[14]朱步先,朱胜华.朱良春用药经验集[M].长沙:湖南科学技术出版社,2007:100.
[2]王睿林.中医体质学的发展与中西医结合[J].天津中医药,2005,22(1):53-55.
[3]Vaughn WT. Allergic migraine[J]. JAMA,1927,88(18):1383-1386.
[4]Unger AH,Unger L. Migraine is an allergic disease[J]. J Allergy,1952,23(5):429-440.
[5]游思惟.作为过敏性疾患的偏头痛临床表现[J].国外医学·神经病学神经外科学分册,1980,5(6):617.
[6]赵英贤,张巧俊,孙秀珍,等.偏头痛的食物变态反应[J].陕西医学杂志,1993,22(11):649-650.
[7]李来刚,韩金安,王昌铭.季节性偏头痛患者过敏原试验与Ig E检测结果分析[J].华北国防医药,2010,22(1):29-30.
[8]许梦雪,曹文英,吴瑾.偏头痛与过敏症的相关性研究进展[J].中国疼痛医学杂志,2018,24(11):851-854.
[9]杨菲,张惠敏,陈雪梅,等.浅谈国医大师王琦教授从调理过敏体质角度治疗偏头痛的思路[J].世界中医药,2015,10(10):1900-1902.
[10]黎婉玲.偏头痛患者的中医体质特征研究[D].广州:南方医科大学,2012.
[11]李柱. 300例偏头痛患者中医体质分布及与中医证候关系临床研究[J].辽宁中医药大学学报,2015(10):13-14.
[12]赵艳敏.女性偏头痛缓解期中医证候及体质分布规律的临床研究[D].郑州:河南中医学院,2015.
[13]栾旭慧.运用体质辨识理论开展偏头痛间歇期辩证施护的构想[J].中医临床研究,2012,4(19):107-109.
[14]朱步先,朱胜华.朱良春用药经验集[M].长沙:湖南科学技术出版社,2007:100.