脱疽(动脉硬化闭塞症)文献辑要  

Research on Gangrene(Arteriosclerosis obliterans)of Ancient Literature

作　　者：李世征[1] 

机构地区：[1]辽宁中医药大学附属医院血管外科,沈阳110032

出　　处：《实用中医内科杂志》2014年第7期12-14,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：动脉硬化闭塞症可归属脱疽范畴。脱疽最早见于《内经》,名为"脱痈","发于足指,名曰脱痈。其状赤黑,死不治;不赤黑,不死。不衰,急斩之,不则死矣";晋代皇甫谧首先提出"脱疽",南北朝龚庆宣也有类似记载;隋代巢元方谓"疽者,五脏不调所生也……",唐代孙思邈论述与《内经》相同,有"在肉则割,在骨则切"的手术主张;到明代已积累了相当丰富的临床经验,尤其是手术外治方面,申斗垣"若色紫黑者急斩去之,如黑上至踝骨不治";王肯堂提出"初发结毒,焮赤肿痛者以五神散及以紫河车、金线钓葫芦、金鸡舌、金脑香捣烂敷及以汁涂敷;又以万病解毒丸磨醋暖涂之"的外敷方法;薛已详论"……先用隔蒜灸、活命饮、托里散,再用十全大补汤、加减八味丸。……重者须当以脚刀转解周界,轻拽去之,……不若灸法为良";陈实功详论病因、病机、症状、治疗及预后,除内服药外,还采用针灸、熏洗、外用药等疗法,附有验案,将手术指征、术前准备、术后护理、手术方法均进行详细说明,较薛已的手术方法更为合理。清代认识更为进步,一些治疗脱疽的名方因此产生,"大人用阳和汤,幼孩以小金丹,最狠者,以犀黄丸皆可消之","脱疽者,……或因房术涩精,丹石补药,销烁肾水,房劳过度,气竭精枯而成",顾步汤能益气养阴,和营清热,脱疽连服此汤可救脚趾俱黑者。Arteriosclerosis obliterans gangrene category. Gangrene was first seen in ＂Nei Jing＂, called ＂de carbuncle＂, ＂in thetoe, called off the carbuncle. Its like red black, death does not treat;not red black, die. Long, sharp cut, don＇t you dead ＂;in Huangfu Mi first proposed the＂ base ＂, the northern and Southern Dynasties Gong Qingxuan also has asimilar record;Chao Yuan Fang Sui called＂ carbuncle, five zang organs do not transfer the students Sun Simiao of the Tang Dynasty, the same with ＂after＂, ＂the meat is cut, operation advocates in the bone cuts＂;to the Ming Dynasty has accumulated rich clinical experience, especially the operation rule, Shen Douyuan ＂if the color purple black people hurry off, such as the black to the ankle is not governanee＂;Wang Kentang put forward the ＂primarynode poison, Xin swollen to five God scattered and the placenta, gold fish, Jin Jishe, gold gourd brain incensesmashed deposited and juice coating;and grinding vinegar warm Tu＂ external method to million sick detoxification pill;Xue has dwelt First with garlic moxibustion, life giving beverage, Tori San, and Shiquan Dabu decoction, plus or minus eight flavour pill . That ought to foot blade rotating solution perimeter, dragged to the light, …… If not for the good ＂moxibustion;Chen Shigong on pathogenesis, symptoms,treatment and prognosis of oral medicine, in addition, also with acupuncture, fumigation, topical drug therapy, with a test case, the operation indications, preoperative preparation, postoperative nursing, operation methods were explained in detail, with Xue operation method is more reasonable. The Qing Dynasty is more progress, some treatment of Tuoju square so, ＂adults with Yang Hetang, the young child to the small saver, the most ruthless, in Xihuang Pill can eliminate the＂, ＂fever＂, Or because the realoperation of acerbity, Dan Shi Shuo kidney tonic, pin water, room service is excessive, and exhausted dry and fine, Gu Bu Tang can Yiqi Yangyin Qingre gangrene, and camp, even

关 键 词：动脉硬化闭塞症 脱疽 脱痈 万病解毒丸 阳和汤 小金丹 犀黄丸 顾步汤 中医药治疗 文献医籍 

分 类 号：R543.5[医药卫生—心血管疾病]