张志斌从脏腑辨治脓耳经验撷菁  

ZHANG Zhibin’s experience in treating Nonger based on viscera differentiation

作　　者：王安琪 陈兰兰 张志斌 WANG Anqi

机构地区：[1]山西中医药大学,山西太原030619 [2]山西中医药大学附属医院,山西太原030024

出　　处：《中医临床研究》2023年第19期142-144,共3页Clinical Journal Of Chinese Medicine

摘　　要：脓耳,中医病名,又名“缠耳、聤耳、耳湿、耳疮”等,是指以耳部疼痛、鼓膜穿孔、耳内流脓、听力下降等为主要临床表现的疾病。西医学的化脓性中耳炎、乳突炎可参考本病进行辨证施治。脓耳的发生的根本原因在于湿与热;湿、热之邪困结于耳窍,腐蚀鼓膜,化腐成脓,终成脓耳。山西中医药大学附属医院张志斌主任,从事耳鼻喉临床诊疗工作多年,擅长将理论基础与临床实践经验有机融合。针对脓耳,根据临床证候表现不同,归纳总结出脓耳多与肾、肝、脾密切相关。临床诊疗中强调脏腑辨证,以补肾固元、疏肝利胆、健脾补托以祛湿排脓。文章介绍案例一则进行佐证,患者甲辨证为肝胆湿热型脓耳,治以疏肝利胆、清利湿热,予龙胆泻肝汤合五味消毒饮,同类相须,药力专一,以期速效之功。三诊后诸症皆愈,疗效确切,提示张主任治疗脓耳的经验成功,遵从扶正不留邪,祛邪不伤正的遣药组方原理,同时酌情联合他法,标本同治,以期为临床提供参考。Nonger(脓耳)is the name of TCM,also known as Chaner(缠耳),tinger(聤耳),Ershi(耳湿),Erchuang(耳疮),etc.,refers to diseases with ear pain,tympanic membrane perforation,ear discharge pus,hearing loss,etc.as the main clinical manifestations.Purulent otitis media and mastoiditis in Western medicine can be treated with reference to this disease.The root cause of Nonger occurrence is humidity and heat.The evil of dampness and heat is trapped in the ear,corroding the eardrum,turning into pus,and finally into pus.ZHANG Zhibin,director of the Affiliated Hospital of Shanxi University of Chinese Medicine,has been engaged in the clinical diagnosis and treatment of otolaryngology for many years,and is good at organically integrating theoretical foundation and clinical practice experience.For Nonger,according to different clinical symptoms,it was summarized that Nonger is closely related to kidney,liver and spleen.In clinical diagnosis and treatment,emphasis is placed on internal organ differentiation,to replenish kidney solids,loosen liver and gallbladder,strengthen the spleen and replenish to dispel dampness and drain pus.The article introduces a case to corroborate,patient A is identified as hepatobiliary moist fever type of Nonger,treatment with liver thinning and gallbladder,clearing humid heat,giving the Longdan Xiegan decoction(龙胆泻肝汤)combined with Wuwei Xiaodu Yin(五味消毒饮),the same kind of must,the medicinal power is single,in order to achieve quick effect.After the three diagnoses,all the symptoms were cured,and the efficacy was accurate,suggesting that Director ZHANG's experience in treating Nonger was successful,and he followed the principle of dispensing medicine to help the right and not leave evil behind,and dispelled evil without harming the right,and at the same time combined with other methods as appropriate,treating the symptoms and the root cause,in order to provide clinical reference.

关 键 词：脓耳 脏腑辨证 经验 

分 类 号：R276.1[医药卫生—中医五官科学]