陈其华从瘀论治慢性前列腺炎经验  

Chen Qihua's Experience of Treating Chronic Prostatitis from Blood Stasis

作　　者：何欢 赵姣 林雅思 陈其华[2] HE Huan;ZHAO Jiao;LIN Yasi;CHEN Qihua(Hunan University of Chinese Medicine,Changsha,Hunan,China,410208;The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China,410007)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《河南中医》2023年第11期1663-1667,共5页Henan Traditional Chinese Medicine

基　　金：2021年度湖南省中医药科研计划重点项目(2021001);2020年度湖南省临床医疗技术创新引导项目(2020SK51403);湖南省研究生教育创新工程和专业能力提升工程项目(CX20200808)。

摘　　要：陈其华教授认为,慢性前列腺炎(chronic prostatitis, CP)以肾虚、脾虚为本,湿热、气滞、瘀血为标,瘀血为疾病之纲要。陈教授治疗该病以通瘀为核心,强调应明确病位、细审病因,随证治之,自拟前列清瘀汤。CP初期病位表浅,多在气分,责之湿热,可酌加车前子、滑石、大黄、山栀子、萆薢等。瘀血初成者可用川芎、香附、延胡索等散瘀利湿止痛;瘀而化热时,用当归、赤芍、牡丹皮、生地黄等凉血化瘀;热象明显者加金银花、白花蛇舌草等;顽证难愈者,瘀血潜伏体内,疼痛甚重,加三棱、莪术等破血化瘀药。病情迁延,患者受病痛折磨,易出现情绪焦躁,甚至影响勃起功能,陈教授认为CP的治疗不能单纯拘泥于精室,肝经与前阴病关系密切,情志不佳者以“川芎-郁金-川牛膝”化瘀、开郁,既调摄消极情绪,又防因郁成瘀。此外,陈教授强调化瘀不忘顾护脾胃,温补脾肾,可加茯苓、陈皮、砂仁健脾醒脾,肾阳亏虚者酌加原蚕蛾、黑蚂蚁、菟丝子、肉苁蓉、肉桂等。陈教授从整体观出发,重视多脏腑、多系统间的相互影响,内外兼治,协同作用。陈教授常根据患者具体情况给予中药坐浴熏洗,穴位贴敷疗法,清热利湿、化瘀药物保留灌肠,针刺治疗等,还参考各项检验检查结果,适当运用抗生素、5α-还原酶抑制剂、磷酸二酯酶抑制剂等。Professor Chen Qihua believes that chronic prostatitis(CP)is due to kidney and spleen deficiency as the root cause,damp-ness-heat,qi stagnation,blood stasis as the manifestations,and blood stasis is the outline of CP.Professor Chen treats the disease with dredging blood stasis as the core,and has formulated Prostatitis Stasis-Clearing Decoction.During the treatment,he emphasizes that the disease location should be clearly defined,the etiology should be carefully examined,and the disease should be treated according to the exact syndrome.At the initial stage of CP,the location is superficial,mostly in the qi aspect,and the dampness-heat is the etiology,so Cheqianzi(Semen Plantaginis),Huashi(Talcum),Dahuang(Radix etRhizomaRhei),Shanzhizi(FructusGardeniae),Bixie(Rhizo-ma Dioscoreae Hypoglaucae),etc.can be added.The initial stage of blood stasis can be treated by dispersing blood stasis and relieving pain with Chuanxiong(Rhizoma Chuanxiong),Xiangfu(Rhizoma Cyperi),Yanhusuo(Rhizoma Corydalis),etc.When the blood stasis is transformed into heat,Danggui(Radix Angelicae Sinensis),Chishao(Radix PaeoniaeRubra),Mudanpi(Cortex Moutan),Shengdi-huang(Radix Rehmanniae),etc.can be used to cool blood and remove blood stasis.When the heat is obvious,Jinyinhua(Flos Lonicerae Japonicae),Baihuasheshecao(Herba Hedyotis Diffusae),etc.can be used.When the persistent syndrome is difficult to cure,blood stasis is latent in the body,and the pain is very serious,Sanleng(Rhizoma Spargani),Ezhu(Rhizoma Curcumae),etc.can be used to promote blood circulation and remove stasis.If the disease is prolonged,the patient is tortured by the pain,prone to emotional anxiety,which even affects the erectile function.Professor Chen believes that the treatment of CP can not be simply limited to the sperm chamber,because the liver meridian is closely related to the anterior yin disease,for the patient with poor emotional state,"Chuanxiong(Rhizoma Chuanxiong)-Yujin(Radix Curcumae)-Chuanniuxi(Radix Cyathulae)"is used to remove blood stasis and relieve depres-sio

关 键 词：慢性前列腺炎 从瘀论治 肾虚 脾虚 瘀血 前列清瘀汤 陈其华 

分 类 号：R259.973.3[医药卫生—中西医结合]