魏志军辨治肛门瘙痒症临床经验  

Clinical Experience of Professor WEI Zhi-Jun in Differential Diagnosis and Treatment of Anal Pruritus

作　　者：张涛[1,2] 吴喜华[2] 李伟林[2] 李华娟 李芳斓 魏志军(指导)[1,2] ZHANG Tao;WU Xi-Hua;LI Wei-Lin;LI Hua-Juan;LI Fang-Lan;WEI Zhi-Jun(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China;Ano rectal Dept.,Shenzhen Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518000 [2]广州中医药大学深圳市中医院肛肠科,广东深圳518000

出　　处：《广州中医药大学学报》2020年第11期2227-2231,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20191270);广东省医学科学技术研究基金项目(编号:A2019454)。

摘　　要：从病因病机、分期论治、辨证论治、用药特点、外洗方药等方面对魏志军教授治疗肛门瘙痒症的临床经验进行了整理。魏志军教授认为肛门瘙痒症的内因多为脾、肺、肾三脏气虚,外因则主要为感受风邪,易夹杂寒、湿、热为患。分期治疗按急性期、亚急性期、慢性期3期进行;内服方以托里愈疡汤(主要由土茯苓、金银花、熟大黄、肉桂、紫花地丁、薏苡仁、太子参、生甘草、升麻、当归、黄芪等组成)为基础方,注重寒热同调、攻补兼施及气血同调。临证时可根据临床病症分脾虚湿蕴、湿热蕴结、风热盛行、血虚风燥4型辨证加减;外用熏洗方需结合内服方使用。同时宜重视肛周日常洗护,注意饮食调节。The clinical experience of Professor WEI Zhi-Jun in the differential treatment of anal pruritus was summarized from the aspects of etiology and pathogenesis,staging treatment,syndrome differentiation and treatment,medication regularity,and external washing prescription.Professor WEI Zhi-Jun believes that the endogenous factor of anal pruritus is related with the qi deficiency of spleen,lung and kidney,and the exogenous factor is predominated by wind pathogen complicated with cold,dampness,and heat.The staging treatment can be classified into the treatment for the acute stage,the treatment for the sub-acute stage,and the treatment for the chronic stage.The internal treatment with Chinese medicine is with Tuoli Yuyang Decoction as the fundamental prescription,which is mainly composed of Rhizoma Smilacis Glabrae,Flos Lonicerae,prepared Radix et Rhizoma Rhei,Cortex Cinnamomi,Herba Violae,Semen Coicis,Radix Pseudostellariae,Radix Glycyrrhizae,Rhizoma Cimicifugae,Radix Angelicae Sinensis,and Radix Astragali,and is characterized by the therapies of simultaneous regulation of cold and heat,simultaneous elimination and reinforcement,and simultaneous regulation of qi and blood.In the clinic,the modification of the medicine can be based on the four syndrome types of spleen deficiency with internal retention of dampness,retention and stagnation of damp-heat,excessive windheat,blood deficiency with wind and dryness.The prescription for external washing application should be combined with the internal medication.Meanwhile,the daily peri-anal nursing and dietary regulation should be taken into account.

关 键 词：肛门瘙痒症 托里愈疡汤 外用熏洗方 魏志军 

分 类 号：R266[医药卫生—中医外科学]