韩氏中医应用攻补汤(丸)的临床经验  

HAN’s clinical experience in the application of the Gongbu decoction(pill)in TCM

作　　者：田巍巍 李凡娥 王华峰 韩文舫 TIAN Weiwei

机构地区：[1]鱼台县人民医院,山东济宁272300 [2]仪陇县中医医院,四川仪陇637600

出　　处：《中医临床研究》2023年第34期99-103,共5页Clinical Journal Of Chinese Medicine

基　　金：齐鲁医派学术流派中医药特色技术传承推广项目:韩氏攻补汤(丸)治肝病中医药特色技术(鲁卫函[2021]45号)-27。

摘　　要：慢性肝病是严重危害人民群众健康的常见和多发疾病之一,中医药治疗具有一定优势,验方攻补汤(丸)专为治疗慢性肝病而设。文章阐述攻补汤的药物组成,临证配伍化裁用药经验。对于慢性肝病的不同阶段,依据临床不同表现,韩氏中医注意在采用攻补汤治疗的基础上用药各有侧重,紧扣病因病机。早中期肝硬化以疏肝理脾、活血化瘀、扶正消癥为治疗大法;慢性肝病后期注意消补兼施,寓消于补,活血不可妄用破血之品。针对肝硬化腹水,注重水、热、血、瘀之间的关系,分清主次慎用峻剂,以缓为治,兼顾肝肾亏虚之所在,理脾补脾各有侧重,结合情志疗法,注意食疗,以缓图效。韩氏攻补汤以肝十二味为组方的基本药物,健脾疏肝,活血消癥,理脾补脾兼施于一炉,气血同调,兼顾肝、脾、肾三脏之间的关系,柔肝不伐肝,健脾顾护胃气为组方要旨,重视服药的时间,辅以心理疏导,注意七情致病,疏肝、柔肝、调达肝气相结合。在治疗时,谨守病机,辨证施治,灵活化裁。方药组成配伍始终体现顾护胃气、健脾疏肝、气血同调的核心思想。韩氏治疗慢性肝病在“肝十二味”的基础上守常达变,临床应用多年疗效突出,安全可靠并形成了特色治疗经验。现将多年临床实践经验简述如下,以期为相关临床治疗提供参考。Chronic liver disease is one of the common and multiple diseases that seriously endanger people’s health.Traditional Chinese medicine has certain advantages in the treatment of chronic liver disease.The Gongbu decoction(pill)[攻补汤(丸)]is specially designed for the treatment of chronic liver disease.This paper expounds the drug composition of the Gongbu decoction and the experience of clinical compatibility.In different stages of chronic liver disease,according to different clinical manifestations,HAN’s TCM medicine pays attention to medication with different emphasis,closely following the etiology and pathogenesis on the basis of the treatment of the Gongbu decoction.Liver cirrhosis in the early and middle stages should be treated by the therapy of soothing the liver and regulating the spleen,promoting blood circulation and removing blood stasis,and strengthening body resistance and dispersing disease.In the later stage of chronic liver disease,attention should be paid to both reinforcing and eliminating,promoting blood circulation but not breaking blood.In the treatment of cirrhotic ascites,we should pay attention to the relationship among water,heat,blood and blood stasis,distinguish between primary and secondary,use strong medicine cautiously,treat the disease slowly,and treat deficiency of liver and kidney simultaneously.Regulating the spleen and tonifying the spleen have their own emphasis,combined with emotional therapy,paid attention to dietotherapy,so as to achieve good results slowly.HAN’s the Gongbu decoction includes twelve basic medicines of the liver,which can invigorate the spleen and soothe the liver,activate blood circulation and disperse disease,regulate the spleen and tonify the spleen,harmonize Qi(气)and blood,and take into account the relationship between the liver,spleen and kidney.The gist of the prescription is to soften the liver without cutting the liver,invigorating the spleen and protecting stomach Qi.Attention should be paid to the time of taking medicine,supplemented by p

关 键 词：攻补汤 活血消癥 虚实夹杂 

分 类 号：R289.5[医药卫生—方剂学]