陆灏以蒿芩清胆汤化裁从三焦论治瘿病经验总结  

Experience Summary of LU Hao Treating Gall Disease with Haoqin Qingdan Decoction(蒿芩清胆汤)Based on“Sanjiao”Theory

作　　者：许嘉慧 陈清光[1] 陆灏[1] XU Jiahui;CHEN Qingguang;LU Hao(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《辽宁中医杂志》2021年第5期38-41,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81503552,81874434);上海市科委科研计划项目(17401970100,14401930600,17401970400,17401970600);中医糖尿病专科联盟建设[ZY(2018-2020)-FWTX-4011];上海市中医临床重点实验室(14DZ2273200);上海市临床重点专科(shslczdzk05401);浦东新区中医联合体建设(PDZY-2019-0601)。

摘　　要：目的归纳总结陆灏教授治疗瘿病的学术思想和临证经验。方法通过跟师学习、交流思考整理陆灏教授临证治疗瘿病之验案,从中医因、机、证、治等方面系统阐述陆灏教授临证思路和处方规律。结果陆灏教授认为瘿病之人多因情志不调、饮食甜腻、地域因素致湿从中生、热从内化,中焦运化失司,则三焦气化失常;结合中医理论三焦与胆经均循颈过颈之循经定位,总结其核心病机在于"湿热中阻,枢经失司,三焦气乱",即湿热为因,气病为本,三焦为变,痰、瘀可为病理产物。治疗上多以蒿芩清胆汤为基础方辨证论治,重在清热利湿、疏利三焦气机,同时强调辨病辨证相结合、症状与病理同注重,组方灵活化裁,效如桴鼓。结论陆灏教授治疗瘿病经验丰富,融汇中医,见解独到,遂将经验归纳总结,附验案2则,以飨读者。Objective To summarize Professor LU Hao′s academic thoughts and clinical experience on treating gall disease.Methods Through studying with tutors, thinking and organizing the cases of Professor LU Hao′s clinical treatment of gall disease, it systematically elaborated Professor LU Hao′s clinical practice and prescription rules from causes, mechanism, symptoms and treatment.Results Professor LU Hao thought that people with gall disease were mostly due to emotional disorder, sweet diet and local factors that caused dampness in the middle and internal heat.The middle-Jiao is weakness in digesting and triple-Jiao Qi movement would be abnormal.Combined with the theory of traditional Chinese medicine, triple-Jiao meridian and the gallbladder meridian are both through the neck, and the core pathogenesis is summarized as "damp-heat resistance, abnormal Qi movement in triple-Jiao",Damp-heat is the cause and Qi disorder is the basis.Phlegm and blood stasis can be the pathological products.Haoqin Qingdan Decoction(蒿芩清胆汤) was selected based on syndrome differentiation and treatment, with emphasis on clearing heat and dampness, dredging Qi movement in triple-Jiao.At the same time, Professor LU Hao emphasizes the combination of disease differentiation and syndrome differentiation, symptoms and pathology, and the formula is flexible and effective.Conclusion Professor LU Hao has extensive experience on treating gall disease and integrating traditional Chinese medicine, and has unique insights.This paper summed up the experience and attached 2 cases for reference to readers.

关 键 词：瘿病 三焦 湿热 蒿芩清胆汤 临床经验 陆灏 

分 类 号：R265[医药卫生—中医外科学]