艾儒棣内外并治四步法治疗阴证皮肤溃疡经验  

AI Rudi's Experience in Treating Skin Ulcer of Yin Syndrome with the“Four-step Method”of Internal and External Treatment

作　　者：宋玮 张钟艺 凌桂华 魏可波 江英培 何鑫 陈明岭[1] 肖敏[1] SONG Wei;ZHANG Zhongyi;LING Guihua;WEI Kebo;JIANG Yingpei;HE Xin;CHEN Mingling;XIAOMin(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072)

机构地区：[1]成都中医药大学附属医院,四川省成都市610072

出　　处：《中医杂志》2023年第9期879-884,共6页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第二届全国名中医工作室建设项目(国中医药人教发[2022]5号)。

摘　　要：总结艾儒棣教授治疗阴证皮肤溃疡的临证经验。根据阴证皮肤溃疡腐肉难脱、肉芽暗淡、脓质稀薄、迁延难愈的皮损特点,认为本病乃正虚不复、湿腐凝聚、血脉阻滞、余毒留恋而发,以虚、瘀、毒、腐为基本病机,采用内外并治四步法进行治疗。第一步提脓祛腐,内治以托里消毒散合二术煎,外治以七星丹;第二步解毒生肌,内治以补血解毒汤,外治以漏芦猪蹄汤;第三步生肌收口,内治以加味乳没散合补中益气汤,外治以皮粘散;第四步敛皮平肌,内治以加味异功散,外治以敛肌散。此四步在临床中既可单独应用,也可联合应用或序贯应用。This paper summarized the clinical experience of AI Rudi in the treatment of skin ulcer of yin syndrome.According to the lesion characteristics of the skin ulcer of yin syndrome,such as the difficult removal of rotting flesh,dim granulation,thin pus and refractory persistence,it is believed that this disease is caused by healthy qi deficiency and unrecovery,dampness and putridity coagulation,blood and vessels obstruction,residual toxin not cleared.The basic pathogenesis is“deficiency,stasis,toxin,and putridity”.Four-step method of internal and external treatment is recommended.The first step is to remove pus and eliminate putridity using Tuoli Xiaodu Powder and Erzhu Decoction(托里消毒散合二术煎)as internal treatment and Qixing Elixir(七星丹)as external treatment.The second step is to remove toxin and engender flesh with Buxue Jiedu decoction(补血解毒汤)as internal treatment and Loulu Zhuti Decoction(漏芦猪蹄汤)as external treatment.The third step is to engender flesh and close sore,using internal treatment with Jiawei Rumo Powder and Buzhong Yiqi Decoction(加味乳没散合补中益气汤),and external treatment with Pinian Powder(皮粘散).The fourth step is to astringe and restore skin and flesh by internal treatment with modified Yigong Powder(异功散)and external treatment with Lianji Powder(敛肌散).The four steps can be applied in separation,in combination,or sequentially.

关 键 词：皮肤溃疡 阴证 名医经验 艾儒棣 

分 类 号：R249[医药卫生—中医临床基础] R26[医药卫生—中医学]