尹常健辨治细菌性肝脓肿经验及用药特色  

Professor YIN Changjian’s Experience in Treating Bacterial Liver Abscess Based on Syndrome Differentiation and His Medication Features

作　　者：张永[1] 张欢 ZHANG Yong;ZHANG Huan(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学,山东济南250355

出　　处：《山东中医杂志》2022年第2期127-132,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目“中医药现代化研究”(编号:2018YFC1704103)。

摘　　要：尹常健教授将细菌性肝脓肿的病机概括为“正虚毒盛、津液壅滞、经络阻塞、气血凝涩”。湿热火毒内蕴为标,气血津液亏耗为本。津液壅滞、肝络不通是发病的关键环节。胆腑不通、胆失洁净是成脓的重要原因。治疗上主张分期论治:早期清热解毒,疏散风热;成脓期穿刺引流配合托里补虚;恢复期以补气生血、养阴生津为主,兼顾解毒消痈、散结通络。强调以调理脾胃、改善消化吸收功能为重点。中医药治疗本病的优势主要体现在快速退热、加速病灶吸收消散、促进患者康复等方面。Professor YIN Changjian summarizes the total pathogenesis of bacterial liver abscess as“deficiency of healthy qi and excessiveness of pathogen,stagnation of body fluid,obstruction of meridians,and coagulation of qi and blood”.The damp heat and fire poison are the symptoms,and the loss of qi,blood and body fluid is the root cause.Body fluid stagnation and liver collateral blockage are the key links of the disease.Gallbladder obstruction and its failure in biliary depuration are important causes of abscess.In terms of treatment,methods and measures for treatment by stages have been proposed.In the early stage,it is necessary to clear away heat and detoxify,and dispel wind and heat.In the purulent stage,puncture and drainage should be combined with tonifying interior deficiency.During the recovery period,the main focus is to replenish qi and blood,nourish yin and promote fluid,and take care of detoxification,eliminating carbuncle,and dispersing congestion and collaterals.Emphasis is laid on regulating the spleen and stomach and improving digestion and absorption.The advantages of traditional Chinese medicine in the treatment of this disease are mainly reflected in the rapid reduction of fever,accelerating the absorption and dissipation of the lesion,and promoting the recovery of the patient’s physical fitness.

关 键 词：细菌性肝脓肿 内痈 病机 辨证论治 分期论治 尹常健 名医经验 

分 类 号：R256.49[医药卫生—中医内科学]