姜德友临证川崎病(温病发斑)辨治思想探析  

Analysis of Jiang Deyou's thoughts on the differential treatment of clinical Kawasaki disease(warm-toxin disease with ecchymoses)

作　　者：宋成彬 姜德友[1] SONG Chengbin;JIANG Deyou(Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040

出　　处：《长春中医药大学学报》2023年第10期1090-1094,共5页Journal of Changchun University of Chinese Medicine

基　　金：国家中医药管理局龙江医学流派传承工作室建设项目(LPGZS2012-14);国家中医药管理局姜德友全国名老中医药专家传承工作室。

摘　　要：川崎病作为急性自限性全身血管炎综合征,以斑疹为主要临床表现,与中医温病发斑相合,并发严重心血管疾病,病情危笃。姜德友教授认为,川崎病以正虚伏邪,郁久化热,迅速传遍,热毒炽盛,内斥营血,外迫气卫,气营两燔为核心病机,病位充斥卫、气、营、血四部。治疗上采用分消热邪、合方思维、一药多用的特色治疗方法,分消热邪则清营凉血散瘀祛热于内、透热卫气逐热于外、利热通淋淡渗于下,三法同用;合方思维,相须为用,相异互补;一药多用,方精功扩,协增新效,保留方剂原有框架、产生新的特色疗法,有效缩短川崎病(温病发斑)的疾病病程,避免严重并发症的发生,对危重症候的缓解及治疗具有显著疗效。Kawasaki disease is an acute self-limiting systemic vasculitis syndrome with maculae as the main clinical manifestation.It is in line with warm-toxin disease with ecchymoses of traditional Chinese medicine.It is accompanied by serious cardiovascular disease and the condition is critical.Professor Jiang Deyou believes that Kawasaki disease spreads rapidly with the healthy qi deficiency latent evil,and prolonged depression transforming into heat;for the disease,heat-toxicity is flaming,with internal repulsion of nutrient-blood,external pressure of defensive qi,and flaring heat in qifen and yingfen as the core pathogenesis.The disease position is filled with the four parts of Wei,Qi,Ying,blood.In the treatment,the characteristic treatment methods of separating and eliminating heat pathogen,thinking of combined prescription,and multiple uses of one meidicine are used.The three methods are used together to separate and eliminate heat pathogen,clear Ying system and cool blood,disperse blood stasis and clear heat in the interior,to clear heat in qifen in the exterior,and to promote heat and free strangury and promote diuresis in the lower.Thinking of combined prescription is to use each other when needed,and to complement each other when different.The multiple uses of one medicine are the essence of the prescription and expansion of its efficacy,together increase of new effects,the retention of the original framework of the prescription,and the production of new characteristic therapies,which effectively shortens the course of Kawasaki disease(warm-toxin disease with ecchymoses),avoids the occurrence of serious complications,and has significant effects on the relief and treatment of critical symptoms.

关 键 词：川崎病 温病发斑 气营两燔 分消热邪 合方思维 一药多用 

分 类 号：R720.5[医药卫生—儿科]