吴雄志“伏邪”分期辨治智齿冠周炎  

WU Xiongzhi(吴雄志) Treating Third Molar Pericoronitis with Fuxie(伏邪) Theory

作　　者：张玉萱 杨凤珍 吴雄志 ZHANG Yuxuan;YANG Fengzhen;WU Xiongzhi(Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer/Key Laboratory of Cancer Prevention and Therapy,Tianjin/Tianjin's Clinical Research Center for Cancer;Tianjin University of Chinese Medicine,Chinese Medicine College,Chinese medicine major of 2013,Tianjin300000,China;Inner Mongolia Mangui Forestry Bureau Staff hospital,Chinese and Western Medicine Department,Hulunbeier 022363,Inner Mongolia,China)

机构地区：[1]天津医科大学肿瘤医院国家肿瘤临床医学研究中心/天津市“肿瘤防治”重点实验室/天津市恶性肿瘤临床医学研究中心 [2]天津中医药大学中医学院,天津300000 [3]内蒙古满归林业局职工医院中西医结合科,内蒙古呼伦贝尔022363

出　　处：《实用中医内科杂志》2018年第10期1-2,6,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金(81473441)~~

摘　　要：吴雄志教授认为智齿冠周炎治疗难点在急性期症状改善后,反复发作、迁延不愈;发作特点与"伏邪"不谋而合,病邪潜伏,伏而后发,智齿阻生形成的盲袋正是邪气潜伏的关键部位,邪气积聚为巢,难以清除,成为反复发作、慢性迁延关键点;急性期症状缓解或消失并不说明疾病治愈,反复发作说明一味使用清热之品,或将疾病慢性化,伏邪依旧存在,唯有抓住伏邪、斩草除根,方可彻底治愈、不再复发。经方发挥,圆机活法,吴师依《伤寒论》六经辨证,据急性期(少阳热化)与慢性期(太阴、少阴寒化)特点,提出托邪外出、寒温并用总则;强调急性发作只要有阳明腑实就应投大黄剂以通腑,以大便转干为邪气外发辨证要点;临证分步治疗:(1)甘草干姜汤合芍药甘草汤,针对大便稀溏发作期,或加上等蜂蜜以增抗炎之效;调胃承气汤针对大便秘结、饮食不节所致发作期;四逆汤、附子理中汤收尾;(2)附子泻心汤合大黄附子汤;(3)三黄片配附子理中丸;(4)柴胡桂枝干姜汤针对平素肝郁脾虚之人,疗效甚佳;其中正邪交争之缓急,全在干姜与天花粉之间剂量调平之妙。附智齿冠周炎(牙咬痈,肾阳虚衰,邪伏脾肾)验案1则。Professor WU Xiongzhi believes that the difficulty in the treatment of third molar pericoronitis is the symptoms are improved after the acute phase,but the disease is still recurrent and prolonged;The characteristics of the attack coincide with Fuxie,the disease lurks first,and then it strikes.Blind bag is formed by the latent disease,which is the key part of the latent disease.The pathogenic factors accumulates as a nest,which is difficult to remove and becomes the key to recurrent and chronic procrastination;The relief or disappearance of symptoms in the acute phase does not mean that the disease is cured.Repeated attacks indicate that the use of heat-clearing drugs blindly will lead to chronic diseases,and that pathogenic factors still exist.Only by grasping the pathogenic factors and killing them all,can it be completely cured,no longer relapse.By using classical preions and syndrome differentiation of six channels theory from Treatise on Cold Pathogenic Diseases flexibly,WU Xiongzhi put forward the general rules of letting the pathogenic factors out and combining cold and heat herbal,according to the characteristics of the acute phase(shaoyang heating) and the chronic phase(Taiyin,Shaoyin colding).Emphasize acute paroxysmal so long as have constipation to use rhubarb apoplexy,constipation is the dialectic point that evil spirit attacks outward;Treatment in different steps:(1) licorice dried ginger decoction combined with peony licorice decoction aims at the attack of the dilute stool.Or use high-quality honey to increase the effect of anti-inflammatory;Tiaowei Chengqi decoctionaims at constipation and improper diet;the Sini decoction and Fuzi Lizhong Decoction are used at last;(2) Fuzi Xiexin decoction and rhubarb dconite decoction;(3) Sanhuang tablets and Fuzi Lizhong pill;(4) Chaihu Guizhi dried ginger decoction for the people who are usually spleen and spleen deficiency,the curative effect is very good;adjusting the dosage of dried ginger and radix trichosanthis can control the intensity of the disease.At

关 键 词：智齿冠周炎 牙咬痈 伏邪 吴雄志 六经辨证 托邪外出 寒温并用 急性期 少阳热化 慢性期 太阴/少阴寒化 智齿阻生盲袋 老中医经验 中医药治疗 

分 类 号：R249[医药卫生—中医临床基础] R276.8[医药卫生—中医学]