王清坚运用“十二纲-病理-方证”辨治颈痹病2则  

The differentiation and treatment of 2 cases of neck arthralgia by applying“Twelve Guidelines-Pathology-Prescription and Syndrome”by WANG Qingjian

作　　者：于亚涛 黄文娟 王猛 林龙 劳永彩 居燕飞 蒙健林 王清坚[2] 陈雅璐 YU Yatao;HUANG Wenjuan;WANG Meng;LIN Long;LAO Yongcai;JU Yanfei;MENG Jianlin;WANG Qingjian;CHEN Yalu

机构地区：[1]广西中医药大学,广西南宁530000 [2]广西中医药大学第一附属医院,广西南宁530023

出　　处：《中医临床研究》2024年第12期135-138,共4页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金委员会地区科学基金项目(81660794);广西高校中青年教师科研基础能力提升项目(2021KY0309);广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210266);广西中医药大学校级科研项目(2021QN016);广西中医药大学第一附属医院院级科研项目(2020QN001)。

摘　　要：颈痹病在临床上为常见肢体痹病之一。随着现代生活水平的不断提高和生活方式的改变,长期保持不当的体态导致颈痹病在临床上日趋多见,且病程长,易反复发作。西医临床多以抗炎、止痛、牵引甚至手术为主要治疗手段,不良反应明显且容易加重患者的经济负担。中医药治疗该病具有简便易行、多种疗法综合运用、疗效较好等特点。中医学认为该病的治疗总原则为扶正祛邪,标本兼治,但在临床实际的诊疗过程中症状往往复杂多变,致使同病难以同治。经方具有药简效宏的特点,而其中蕴含的辨证过程却是微妙严谨的。“十二纲-病理-方证”是王清坚教授在胡希恕先生“六经-八纲-方证”辨证的基础上构建的,该辨证体系的核心在于以“阴、阳、表、里、寒、热、虚、实、气、血、水、食”等十二纲为基础辨证要点归纳、总结患者的症状及体征,从而得出该疾病的“证”也即“病理状态”,进而以“方证对应”的原理遣方用药,在减弱了辨病的同时更加注重整体的“病理状态”,在临床上运用时能快速而准确地抓住疾病的辨证要点并施治,疗效显著。文章尝试浅析王清坚教授治疗颈痹病的2则验案来展现“十二纲-病理-方证”在临床中的应用,介绍其辨证施治的过程,以飨同道。Neck arthralgia is one of the common limb arthralgia in clinic.With the continuous improvement of modern living standards and changes in lifestyle,maintaining improper posture for a long time leads to neck arthralgia being increasingly common in clinical practice,and the course is long and it is easy to reoccur.In Western medicine,anti-inflammation,pain relief,traction and even surgery are the main treatment methods,which have obvious adverse reactions and can easily increase the economic burden of patients.Traditional Chinese medicine treatment of this disease has the characteristics of being simple and easy,comprehensive application of a variety of therapies,and good curative effects.Traditional Chinese medicine believes that the general principle of the treatment of this disease is to promote the healthy Qi(气)and dispel the evil,and treat both the symptoms and root causes.However,in the actual clinical diagnosis and treatment process,the symptoms are often complex and changeable,resulting in difficulty in treating the same disease by the same metha.Classic prescriptions have the characteristics of simple and effective medicine,but the syndrome differential process is subtle and rigorous.“Twelve Guidelines-Pathology-Prescription and Syndrome”,which is proposed by Professor WANG Qingjian,is fast and accurate in the syndrome differentiation and treatment of diseases in clinic.It is based on“Six Channels-Eight Principles-Prescription corresponding to Syndrome”,which is first put forward by Mr.HU Xishu,a famous master of prescriptions.The core of the treatment system is to summarize the symptoms and signs of patients based on the key points of syndrome differentiation including“Yin(阴),Yang(阳),exterior,interior,cold,heat,deficiency,excess,Qi,blood,effusion and accumulation”,thus obtaining the“syndrome”of the disease,namely the“pathological state”,and then using the principle of“Prescription and syndrome”to prescribe drugs.It reduces disease discrimination and pays more attention to the

关 键 词：十二纲-病理-方证 颈痹病 桂枝加葛根汤 验案 

分 类 号：R242[医药卫生—中医临床基础]