防己茯苓汤加味治疗帕金森病验案  

A proved case of Fangji Fuling decoction in the treatment of Parkinson’s disease

作　　者：董吉阳 罗凯 赵曼丽[2] DONG Jiyang;LUO Kai;ZHAO Manli

机构地区：[1]山东中医药大学,山东济南250014 [2]潍坊市中医院,山东潍坊261000

出　　处：《中医临床研究》2023年第30期72-74,共3页Clinical Journal Of Chinese Medicine

摘　　要：帕金森病是中老年人常见神经系统变性疾病,以肌强直、运动迟缓、静止性震颤等为突出临床特征。本病属中医学“颤证”“颤振”范畴,发病早期不影响患者的日常工作生活,但随着时间推移,病情逐渐加重,晚期因全身僵硬而活动艰难甚至长期卧床,最后死于肺炎、压疮感染等多种并发症。西医治疗多以维持症状为主,效果欠佳,不良反应较多,中医药在颤证治疗上有独特之处。导师赵曼丽教授博览古籍,医术精湛,在帕金森病治疗方面有独到的见解,提出该病病机为脾虚湿盛,水气溢表,困遏阳气,阴阳相搏的脾气亏虚、水泛肌表型颤证,可用防己茯苓汤加味治疗。防己茯苓汤始见于《金匮要略》一书,《金匮要略·水气病脉证并治第十四》:“皮水为病,四肢肿,水气在皮肤中,四肢聂聂动者,防己茯苓汤主之。”本方由防己、茯苓、黄芪、桂枝、甘草共五味药组成,具有益气健脾、温阳利水之功,现代临床常用本方治疗肝硬化腹水、心衰性水肿、贫血性水肿、特发性水肿等水肿性疾病。赵曼丽教授对防己茯苓汤的扩展性应用扩大了防己茯苓汤的应用范围,拓展了临床诊治疾病的思路。文章选取赵曼丽教授使用防己茯苓汤治疗帕金森病验案1则,阐述其治疗经验,分析其辨证思路。Parkinson’s disease is a common neurological degenerative disease in the middle-aged and elderly,which manifests in the clinical prominent features of myotonia,bradykinesia,resting tremor,etc.The disease belongs to the category of“flutter syndrome”and“flutter”in traditional Chinese medicine.In the early stage of the disease,it does not affect the patients’daily work and life,but with the passing of time,the condition gradually worsens.In the late stage,due to the stiffness of the whole body,it is difficult to move,patients must stay in bed for a long time,and finally die of pneumonia,pressure sore infection and other complications.Western medicine treatment mainly targets the major symptoms,the effect is not ideal,and there are many adverse reactions.Traditional Chinese medicine has unique advantages in the treatment of tremor syndrome.The tutor,Professor ZHAO Manli has extensive readingof ancient books and excellent medical skills.The tutor has her own unique insights in the treatment of Parkinson’s disease.The tutor proposes that the pathogenesis is spleen deficiency and excess dampness due to water and Qi(气)overflowing,and that for water overflowed myotypic tremor caused by Qi deficiency of spleen due to Yin(阴)and Yang(阳)imbalance,Fangji Fuling decoction(防己茯苓汤)can be used to treat the disease.Fangji Fuling decoction is first recorded in Jin’gui Yaolue.Jin’gui Yaolue•pulse,syndrome and treatment of water Qi disease NO.14 records that“Water disease in skin manifests in swollen limbs,moisture in the skin,limb tremor,which can be prevented and treated with Fangji Fuling decoction.”The prescription is composed of Fangji(Radix stephaniae tetrandrae),Fuling(Poria),Huangqi(Astragalus),Guizhi(Cassia twig)and Gancao(Licorice),and it has the function of invigorating Qi and spleen,warming Yang and promoting diuresis,and it is commonly used in modern clinical treatment of cirrhosis ascites,heart failure edema,anemic edema,idiopathic edema and other edema diseases.Professor ZHAO Manli

关 键 词：帕金森病 颤证 防己茯苓汤 验案 

分 类 号：R277.7[医药卫生—中医学]