林雁从三阴寒毒分层辨治慢性骨髓炎经验  

LIN Yan’s Experience in Multileveled Differentiation and Treatment of Chronic Osteomyelitis from Cold Toxins in Three Yin

作　　者：倪博文 李丰军 孙彦 NI Bowen;LI Fengjun;SUN Yan(Weihai Municipal Hospital Affiliated to Shandong University,Weihai 264200,China)

机构地区：[1]山东大学附属威海市立医院,山东威海264200

出　　处：《山东中医杂志》2024年第6期628-634,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：威海市中医药科技项目(编号:2021N-26)。

摘　　要：林雁认为慢性骨髓炎的病因病机是正虚蕴蓄寒毒,提出将以脉证为核心的慢性骨髓炎“五大证候”(脉、骨、脓、肿、全身症状)与三阴层次、脏腑气血联系起来进行辨证的观点,并运用中西医结合分层法将本病分为少阳太阴合病证(溃脓期)、少阴沉寒证(炎症静止期)、厥阴复阳证(急性发作期)、厥阴寒瘀证(骨痂瘢痕期)。治疗方面强调以“透彻寒毒”为基本治法,热风药、凉风药的运用贯穿始终,并根据各层次证候特点匹配针对性的治法,以提高临床疗效。附验案1则。LIN Yan believes that the cause and pathogenesis of chronic osteomyelitis is the accumulation of cold toxins due to the deficiency of the healthy qi.She proposes conducting a comprehensive syndrome differentiation by linking the differentiation of the pulse-centered“Five Major Syndromes”(pulse,bone,pus,swelling,and systemic symptoms)of chronic osteomyelitis with three yin syndrome differentiation,visceral syndrome differention,and qi-blood syndrome differentiation.Using an integrated approach of traditional Chinese and western medicine,the disease is divided into Shaoyang-Taiyin combined syndrome(suppurative phase),accumulated coldness in Shaoyin syndrome(inflammatory quiescent phase),recurrent Yang in Jueyin syndrome(acute attack phase),and coldness and blood stasis in Jueyin syndrome(bone scab scar phase).In terms of treatment,she emphasizes“thoroughly dispelling cold toxins”as the fundamental method,with the use of hot wind medicinals and cool wind medicinals running through the entire process.Targeted treatment methods are matched according to the characteristics of syndromes at different levels to improve clinical efficacy.One proved case is attached.

关 键 词：慢性骨髓炎 寒毒 三阴 分层治疗 透彻寒毒 

分 类 号：R274.9[医药卫生—中西医结合] R249[医药卫生—中医骨伤科学]