从“毒、热、瘀、虚”论治肾病下肢疮疡探析  

Exploring the Treatment of Lower Limb Sores in Nephropathy from the Perspective of“Toxin,Heat,Stasis,and Deficiency”

作　　者：周岐鸣 郑烈 杜林柯 戴彦成 傅晓骏 Zhou Qiming;Zheng Lie;Du Linke;Dai Yancheng;Fu Xiaojun(Lanxi Hospital of Traditional Chinese Medicine,Zhejiang,Lanxi 321100,China)

机构地区：[1]浙江省兰溪市中医院,浙江兰溪321100 [2]陕西省中医医院,陕西西安710003 [3]上海中医药大学附属上海市中西医结合医院,上海200082 [4]浙江省金华市中医医院傅晓骏名中医工作室,浙江金华320000

出　　处：《中国中医急症》2023年第8期1378-1380,1391,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81873253);陕西省自然科学基础研究计划一般项目[(面上)2019JM-580];陕西省中医药管理局科研项目(2019-ZZ-JC010);陕西省中医医院“苗圃培优”计划项目(2021-07);陕西省中医医院院级课题(2018-04);浙江省中医药科学研究基金项目A类立项(2020ZA119);金华市中医药科技计划项目;软科学研究项目计划2。

摘　　要：基于“脾主肌肉”理论,细心品读《疡科纲要》后在其基础上创新性提出从“毒、热、瘀、虚”来治疗肾病下肢疮疡疾病的学术思想。肾病下肢疮疡病与毒、热、瘀、脾虚关系密切,脾虚是致病之本,久病及肾,毒热瘀是致病之标,三者相互影响,始终贯穿疾病,伏毒不解,变化多端。治疗肾病下肢疮疡疾患无外乎从“毒、热、瘀”三邪的干扰破坏,及其内在“虚”所致正气不足、脾不生肌来论治,治疗上,固护脾肾是关键大法,同时注重清热解毒、利湿活血之法以防疾病传变。故治疗应分清虚实,正邪病因,通过辨证辨病相结合来临证论治,方可起到有的放矢,效如桴鼓之验,并附验案一则。This article is mainly based on the theory of“spleen governing muscles”.After carefully reading the Outline of Ulcers,the authors innovatively proposes the academic idea of treating lower limb ulcers in nephropathy from the perspectives of“toxin,heat,stasis,and deficiency”.Nephrotic lower limb ulcers are closely related to toxins,heat,stasis,and spleen deficiency.Firstly,spleen deficiency is the fundamental cause of disease,and prolonged illness can easily affect the kidneys;secondly,toxin,heat,and stasis are important pathogenic factors,and they interact with each other throughout the entire process of the disease;finally,due to the long-term hidden toxins in the body,diseases often manifest in a variety of ways.In the treatment of lower limb ulcers and ulcers caused by nephropathy,there is no external interference or destruction from the three evils of“toxin,heat,and stasis”,as well as the internal“deficiency”that leads to insufficient qi and the inability of the spleen to produce muscles.In terms of treatment,strengthening the spleen and kidney is the key method,while paying attention to the methods of clearing heat,detoxifying,promoting dampness,and promoting blood circulation to prevent disease transmission.Therefore,treatment should distinguish between deficiency and excess,as well as the causes of good and evil.By combining syndrome differentiation and disease differentiation,good results can be achieved,and an effective medical record is attached.

关 键 词：下肢疮疡 脾主肌肉 《疡科纲要》 脾虚 

分 类 号：R692[医药卫生—泌尿科学]