国医大师葛琳仪浅谈痔术后“气”的演变及诊治规律  

Discussion on the Qi Pathogenesis, Diagnosis and Treatment Characteristics in the Healing of Hemorrhoids Postoperation By The Master of TCM GE Linyi

作　　者：孙灵钰 徐素美[2] 方征宇[2] 张烁(指导)[2] SUN Lingyu;XU Sumei;FANG Zhengyu(Zhejiang Chinese Medical University,Hangzhou(310053),China;The First Affiliated Hospital of Zhejiang Chinese Medical University)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江中医药大学附属第一医院

出　　处：《浙江中医药大学学报》2022年第7期734-736,740,共4页Journal of Zhejiang Chinese Medical University

基　　金：第三届国医大师传承工作室及全国名中医传承工作室建设项目(国中医药办人教函[2018]119号);浙江省中医药重点研究项目(2020ZZ007);浙江中医药大学校级科研项目(2019ZY02)。

摘　　要：[目的]总结葛琳仪教授治疗痔术后并发症的经验。[方法]分析葛老对痔术后并发症病因病机的认识,阐述葛老治“气”的理论基础及诊治规律,并列举一则验案加以佐证。[结果 ]葛老指出,痔术后并发症的主要病机是“三焦气化不利,瘀血阻滞经络”,倡导内外兼治,内服拟清肺润肠、调气运中、清热活血以疏利三焦气机,外治采用自制膏药局部外敷联合脐疗法行气活血、祛瘀生新、收敛生肌,从而促进局部创面愈合。文中所附医案,葛老辨证属三焦气化不利,局部瘀血阻络,选择内外兼治,内治清肺润肠、调气运中、清热活血,方拟仙方活命饮加减;外治行气活血、祛瘀生新、收敛生肌,予自制膏药局部外敷联合芒硝敷脐,疗效颇佳。[结论]葛老从“气”论治痔术后并发症,内外兼治,经验独到,值得学习并推广运用。[Objective] To summarize Professor GE Linyi’s clinical experience in the treatment of postoperative complications of hemorrhoids.[Methods] The paper analyzed Professor GE’s clinical experience in the etiology and pathogenesis of postoperative complications of hemorrhoids, the theoretical basis of Qi and clinical diagnosis and treatment ideas. A typical medical case was listed as proof. [Results]Professor GE proposes that the main pathogenesis of postoperative complications of hemorrhoids is that “tri-Jiao Qi movement is interrupted, blood stasis blocks meridians”, the treatments should include both internal and external methods. Internal treatment means“clearing the lung, moistening the intestines, regulating Qi circulation, clearing heat and promoting blood circulation” to comb tri-Jiao Qi movement. External application of plaster combined with umbilicus therapy is used to promote Qi movement and blood circulation, remove blood stasis and generate new, astringent and generate muscle. The methods above could ensure the recovery of the body and promote the local healing of the wound. In the medical record attached to the article, Professor GE identified that tri-Jiao Qi movement was interrupted, and blood stasis blocked meridians, she advocated treatment with both internal and external methods. Internal treatment was to clear the lung, moisten the intestines, regulate Qi circulation, clear heat and promote blood circulation, and the modified Xianfang Huoming Drink was adopted. External treatment was to promote Qi movement and blood circulation, remove blood stasis and generate new, astringe and generate muscle, and the prescription was external application of plaster combined with umbilicus therapy. The curative effect was quite good. [Conclusion] Professor GE treats postoperative complications of hemorrhoids based on the theory of Qi with both internal and external methods. The experience is unique, which is worthy of study and clinical application.

关 键 词：痔术后 气 内外兼治 膏药 创面愈合 医案 国医大师 葛琳仪 

分 类 号：R574[医药卫生—消化系统]