范瑞强分期论治带状疱疹及其后遗神经痛经验
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摘要
总结范瑞强教授分期辨证论治带状疱疹及后遗神经痛的诊治思路和临床用药经验。范瑞强教授认为本病急性期主要分为肝经郁热证和脾虚湿蕴证,可分别运用龙胆泻肝汤和除湿胃苓汤加减治疗。后期以气滞血瘀证为主,可用柴胡疏肝散合桃红四物汤加减治疗。后遗神经痛患者常见阴虚血瘀证,治疗当以一贯煎合血府逐瘀汤加减。另外重视内外结合,倡导发挥中医外治法的优势。
In this paper,we summarized the clinical experience of professor FAN Rui-Qiang in treating herpes zoster and post-herpetic neuralgia(PHN)by staging differentiation.Professor FAN suggested that herpes zoster patients in acute stage can usually be differentiated into the syndromes of heat stagnation in liver meridian and spleen deficiency with dampness retention,which can be treated with modified Longdan Xiegan Decoction,Chushi Weiling Decoction respectively;herpes zoster patients in late stage are usually classified into the syndrome of Qi stagnation and blood stasis,and can be treated with modified Chaihu Shugan Powder plus Tao Hong Siwu Decoction;herpes zoster patients in late stage characterized by post-herpetic neuralgia can be differentiated into Yin deficiency and blood stasis syndrome,and can be usually treated with modified Yiguan Jian plus Xuefu Zhuyu Decoction.Furthermore,external therapy is stressed by Professor FAN on the basis of oral administration of herbal medicine.
In this paper,we summarized the clinical experience of professor FAN Rui-Qiang in treating herpes zoster and post-herpetic neuralgia(PHN)by staging differentiation.Professor FAN suggested that herpes zoster patients in acute stage can usually be differentiated into the syndromes of heat stagnation in liver meridian and spleen deficiency with dampness retention,which can be treated with modified Longdan Xiegan Decoction,Chushi Weiling Decoction respectively;herpes zoster patients in late stage are usually classified into the syndrome of Qi stagnation and blood stasis,and can be treated with modified Chaihu Shugan Powder plus Tao Hong Siwu Decoction;herpes zoster patients in late stage characterized by post-herpetic neuralgia can be differentiated into Yin deficiency and blood stasis syndrome,and can be usually treated with modified Yiguan Jian plus Xuefu Zhuyu Decoction.Furthermore,external therapy is stressed by Professor FAN on the basis of oral administration of herbal medicine.
引文
[1]Gross G,Schofer H,Wassilew S,et al.Herpes zoster guideline of the German Dermatology Society(DDG)[J].J Clin Virol,2003,26(3):277.
[2]Gershon A A,Gershon M D,Breuer J,et al.Advances in the understanding of the pathogenesis and epidemiology of herpes zoster[J].J Clin Virol,2010,48(Suppl 1):S2.
[3]Kawai K,Rampakakis E,Tsai T F,et al.Predictors of postherpetic neuralgia in patients with herpes zoster:a pooled analysis of prospective cohort studies from North and Latin America and Asia[J].Int J Infect Dis,2015,34(Suppl 3):126.
[4]Dworkin R H,Portenoy R K.Pain and its persistence in herpes zoster[J].Pain,1996,67(2-3):241.
[5]范瑞强,禤国维.中西医结合治疗皮肤病性病[M].广州:广东人民出版社,2005:137.
[6]范瑞强,邓丙戌,杨志波.中医皮肤性病学[M].北京:科学技术文献出版社,2010:54.
[7]潘一峰,章丹丹,凌霜,等.南刘寄奴总黄酮体抗血管炎症的机制分析[J].中国中药杂志,2012,37(17):2597.
[8]赵敏,聂晶.试论威灵仙功用[J].中国中医基础医学杂志,2017,23(1):119.
[9]刘仕琦,李菲,李俊莲,等.威灵仙不同炮制品抗炎镇痛作用的研究[J].山西中医学院学报,2016,17(4):16.
[10]徐龙生,冯勤丽,张小平,等.蜈蚣全蝎散镇痛效应及毒副作用实验研究[J].中华全科医学,2018,16(3):346.
[11]姜开洋,董莉丽.瓜蒌全蝎汤联合火针治疗老年带状疱疹后神经痛的疗效评价[J].重庆医学,2017,46(31):4411.
[2]Gershon A A,Gershon M D,Breuer J,et al.Advances in the understanding of the pathogenesis and epidemiology of herpes zoster[J].J Clin Virol,2010,48(Suppl 1):S2.
[3]Kawai K,Rampakakis E,Tsai T F,et al.Predictors of postherpetic neuralgia in patients with herpes zoster:a pooled analysis of prospective cohort studies from North and Latin America and Asia[J].Int J Infect Dis,2015,34(Suppl 3):126.
[4]Dworkin R H,Portenoy R K.Pain and its persistence in herpes zoster[J].Pain,1996,67(2-3):241.
[5]范瑞强,禤国维.中西医结合治疗皮肤病性病[M].广州:广东人民出版社,2005:137.
[6]范瑞强,邓丙戌,杨志波.中医皮肤性病学[M].北京:科学技术文献出版社,2010:54.
[7]潘一峰,章丹丹,凌霜,等.南刘寄奴总黄酮体抗血管炎症的机制分析[J].中国中药杂志,2012,37(17):2597.
[8]赵敏,聂晶.试论威灵仙功用[J].中国中医基础医学杂志,2017,23(1):119.
[9]刘仕琦,李菲,李俊莲,等.威灵仙不同炮制品抗炎镇痛作用的研究[J].山西中医学院学报,2016,17(4):16.
[10]徐龙生,冯勤丽,张小平,等.蜈蚣全蝎散镇痛效应及毒副作用实验研究[J].中华全科医学,2018,16(3):346.
[11]姜开洋,董莉丽.瓜蒌全蝎汤联合火针治疗老年带状疱疹后神经痛的疗效评价[J].重庆医学,2017,46(31):4411.