胡金辉教授从“郁”论治乳房血栓性浅静脉炎经验  

Professor HU Jinhui’experience in treating breast superficial thrombophlebitis from the aspect of depression

作　　者：李园园 胡金辉[1] 周小湘 杨争[1] LI Yuanyuan

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410021

出　　处：《中医临床研究》2024年第28期65-69,共5页Clinical Journal Of Chinese Medicine

基　　金：湖南省自然科学基金面上项目(2023JJ30470);湖南省自然科学基金科卫联合项目(2023JJ60346)。

摘　　要：血栓性浅静脉炎好发于四肢,其次是胸腹壁(乳房),是沿体表可视浅静脉走行的非化脓性急性炎症,属于中医“青蛇毒”的范畴。该病大多不能自行缓解,易反复发作,降低患者生活质量,且有潜在的严重并发症。现代医学对于该病的病因及治疗尚未统一。胡金辉教授根据该病临床发生发展规律,认为其多出现在情绪波动之后,气郁是本病的起始因素,肝失疏泄,肝气郁结,气滞血瘀,肝郁犯脾,脾失健运,痰浊内生,气、痰、瘀三者相互影响,相互胶结于乳络而发为本病。气郁、痰郁、血郁(瘀)是乳房血栓性浅静脉炎的主要病机。“郁”作为疾病之根本,贯穿疾病的发生发展。临床中应四诊合参,辨证论治,从“郁”论治,郁者达之,治疗上当以疏肝理气解郁散结、健脾益气化痰散结、活血祛瘀消癥散结为主,在桃红四物汤合逍遥散的基础上随病情变化加减用药。此外,胡金辉教授会根据患者的局部及全身症状分辨阴阳,发挥传统中医药的优势,并将中药汤剂内服与膏药外贴相结合,内外合治,缩短病程,减轻患者痛苦,疗效显著,值得借鉴。Superficial thrombophlebitis is a non-suppurative acute inflammation along the visible superficial veins of the body surface,commonly appears in the extremities,followed by the thoracoabdominal wall(breast).The disease belongs to the category of green snake venom in traditional Chinese medicine.The disease often cannot be relieved by itself,is easy to recur,reduce the quality of life of patients,and has potential serious complications.The etiology and treatment of this disease have not been unified in modern medicine.According to the clinical occurrence and development rules of the disease,Professor HU Jinhui believes that the disease mostly appears after mood swings,and Qi(气)depression is the starting factor of the disease,namely,liver dysfunction leads to liver Qi stagnation,resulting in Qi stagnation and blood stasis,additionally,liver depression invades spleen,leadting to dysfunction of spleen in transportation,which causes endogenous sputum turbidity,that is,Qi,phlegm and blood stasis affect each other,cementing each other in the breast mammary collateral and causing this disease.Qi stagnation,phlegm stagnation,and blood stagnation(stasis)is the main pathogenesis of breast superficial thrombophlebitis.Depression as the root of the disease,runs through the occurrence and development of the disease.In the clinic,the four diagnoses should be combined for TCM syndrome differentiation and treatment.In terms of treating diseases from the aspect of depression,the treatment principle is to disperse stagnation,and the treatment methods are mainly soothing liver and relieving stagnation,strengthening spleen and dissolving phlegm,and promoting blood circulation and eliminating mass,so as to invigorate Qi and dissipate knots.On the basis of the Taohong Siwu decoction(桃红四物汤)and Xiaoyao San(逍遥散),the right medicines are increased or decreased with the change of the disease condition.In addition,Professor HU Jinhui distinguishes Yin(阴)and Yang(阳)according to the local and systemic symptoms of patients,

关 键 词：血栓性浅静脉炎 郁 临床经验 

分 类 号：R271[医药卫生—中医妇科学]