肝胆湿热黄疸治疗思路浅析  

Experience on the Treatment of Jaundice of Liver and Gallbladder Dampness Heat Syndrome by LV Guoqing Studio

作　　者：于华林 魏芹 任娟娟 陈树泉 YU Hualin;WEI Qin;REN Juanjuan;CHEN Shuquan(Ji’nan Integrated Traditional Chinese and Western Medicine Hospital,Shandong Ji’nan 271100,China)

机构地区：[1]山东省济南市中西医结合医院,山东济南271100

出　　处：《中医药临床杂志》2024年第5期849-855,共7页Clinical Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(吕国清传承工作室)(国中医药人教发〔2016〕42号);济南市卫生健康委员会科技计划项目(济卫科教发〔2020〕8号);济南市卫生健康委员会科技计划项目(济卫科教发〔2022〕2号)。

摘　　要：文章通过撷取临床验案六则:慢性乙型病毒性肝炎案、乙型肝炎后肝硬化失代偿期伴肝衰竭案、乙型肝炎肝硬化后伴肝癌案、药物性肝损害案、酒精性肝硬化失代偿期伴肝衰竭案、酒精性肝损害伴肝衰竭案等,逐一分析总结治疗黄疸的辨病辨证过程以及治疗用药思路;医案力求反映临床原貌,结合辅助检查结果客观反映治疗效果,并以按语形式总结治疗心得体会。纵观验案,饮食不节,嗜食肥甘厚味,过量饮酒,为黄疸的常见诱发因素;病机抓住湿,治疗上利湿与健脾并举,以期“培土制水”;用药顾护脾胃,“正气内存,邪不可干”,维护好后天之本;淡渗利湿之药,中病即止。治疗思路力求简单明了,用药精简对症,临床上期望达到执简驭繁,收到立竿见影之效。article extracts six clinical cases:the case of chronic hepatitis B virus,the case of decompensated cirrhosis with liver failure after hepatitis B,the case of hepatitis B cirrhosis with liver cancer,the case of drug-induced liver damage,Cases of decompensated alcoholic cirrhosis with liver failure,cases of alcoholic liver damage with liver failure,etc.,analyze and summarize the disease differentiation process and treatment and medication ideas for the treatment of jaundice one by one;the medical records strive to reflect the original clinical appearance,combined with the objective results of auxiliary examinations Reflect the treatment effect and summarize the treatment experience in the form of notes.A review of the case studies shows that improper diet,craving for rich,sweet and rich foods,and excessive drinking are common predisposing factors for jaundice.The pathogenesis of jaundice is caused by dampness,and treatment should focus on diuresis and strengthening the spleen in order to“cultivate the soil and make water”;use medication to provide care.The spleen and stomach,“the healthy Qi is stored in it,and the evil cannot be disturbed”,which maintains the acquired foundation;the medicine that dilutes and dilutes the dampness can stop the disease.The treatment ideas should be simple and clear,and the medication should be concise and symptomatic.Clinically,it is expected to be simple and complex,and achieve immediate results.

关 键 词：黄疸 肝胆湿热 培土制水 健脾利湿 茵陈蒿汤 五苓散 

分 类 号：R25[医药卫生—中医内科学] R256.41[医药卫生—中医学]