陈渭良治疗小儿股骨头坏死经验总结  

Experience of CHEN Wei-Lang in Treating Femoral Head Necrosis in Children

作　　者：陈茹 张念军[2,3,4] 李雪 邓向亮[5] 张兆华 杨海韵 CHEN Ru;ZHANG Nian-Jun;LI Xue;DENG Xiang-Liang;ZHANG Zhao-Hua;YANG Hai-Yun(Shunde Hospital of Southern Medical University,Foshan 528300 Guangdong,China;Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Foshan 528000 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;CHEN Wei-Liang Famous Physician Studio,Foshan 528000 Guangdong,China;Guangdong Pharmaceutical University,Guangzhou 510006 Guangdong,China)

机构地区：[1]南方医科大学顺德医院,广东佛山528300 [2]广州中医药大学附属佛山市中医院,广东佛山528000 [3]广州中医药大学,广东广州510405 [4]陈渭良名医工作室,广东佛山528000 [5]广东药科大学,广东广州510006

出　　处：《广州中医药大学学报》2021年第5期1046-1050,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：佛山市医学科研项目(编号:20190388)。

摘　　要：总结陈渭良教授治疗小儿股骨头坏死经验。陈渭良教授认为,小儿股骨头坏死辨证病位着眼于肝、脾、肾三脏,病理因素与瘀血、痰浊、水湿(湿热)相关,先天肾气不足,外伤劳损,骨骺血脉受损,气血运行受阻是小儿股骨头坏死的基本病机,股骨头局部缺血和外伤是主要原因。治疗上早期多从脾失健运、食积湿滞入手,以健脾化湿、消积导滞为法,遣方大安丸、参苓白术散、白茅根汤加减,中后期以补益肝肾、益气健脾为主,遣方自拟经验方骨宝丸(主要由龟甲、鹿角、淫羊藿、红参、黄芪、淮山、杜仲、枸杞子、山茱萸、熟地黄、巴戟天、仙茅、当归、川芎等组成)。提出内服外敷并重,推荐运用支具,限制患肢负重,强调坚持治疗。The experience of professor CHEN Wei-Liang in treating femoral head necrosis in children was summarized.Professor CHEN Wei-Liang believes that the location of disease of femoral head necrosis in children involves the liver,spleen,and kidney.The pathological factors of femoral head necrosis in children are related to blood stasis,phlegm turbidity and dampness(in particular damp heat).Insufficiency of kidney qi,traumatic injuries and overstrain,impairment of epiphyseal blood vessels,and obstruction of the circulation of qi and blood contribute to the basic pathogenesis of femoral head necrosis in children.The main etiological factors of the femoral head necrosis in children involve the local ischemia and traumatic injuries.For the treatment of femoral head necrosis in children in the early period,Professor CHEN Wei-Liang considers that the treatment should be focused on the pathogenesis of the spleen failing in transportation,indigestion and dampness accumulation,the therapies of invigorating the spleen to resolve dampness,promoting digestion to remove food retention can be used,and the treatment can be achieved by the modification of Da’an Pills,Shen Ling Baizhu Powder,and Baimaogen Decoction.For the treatment of femoral head necrosis in children in the middle and late period,the therapies of tonifying liver and kidney,replenishing qi and invigorating spleen can be used,and the treatment can be achieved by the utilization of Gubao Pills,a self-prescribed recipe mainly composed of Carapax et Plastrum Testudinis,Cornu Cervi,Herba Epimedii,Radix Ginseng Rubra,Radix Astragali,Rhizoma Dioscoreae,Cortex Eucommiae,Fructus Lycii,Fructus Corni,Radix Rehmanniae Preparata,Radix Morindae Officinalis,Rhizoma Curculiginis,Radix Angelicae Sinensis,and Rhizoma Chuanxiong.During the treatment,the simultaneous application of oral and external usage of the medicine,utilization of the orthosis,limitation of the affected limb to bear the weight,and persistent treatment are recommended by Professor CHEN Wei-Liang.

关 键 词：小儿股骨头坏死 健脾化湿 消积导滞 补益肝肾 内服外敷 陈渭良 

分 类 号：R274.39[医药卫生—中医骨伤科学]