曹烨民治疗硬皮病性坏疽经验掇萃  

Summary of Cao Yemin's experience in treating scleroderma gangrene

作　　者：陈惠婉 曹烨民 CHEN Huiwan;CAO Yemin(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai TCM‑Integrated HospitalAffiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海中医药大学附属上海市中西医结合医院,上海200082

出　　处：《上海中医药杂志》2024年第12期86-90,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国基层名老中医药专家传承工作室建设项目(Z155080000004);中国政府奖学金(2022GX2007468);上海市卫健委上海市名老中医学术经验研究工作室建设项目(SHGZS-202248);上海市卫健委临床研究专项(20224Y0387);上海市虹口区卫健委中医药科研课题(HKQGYQY-ZYY-2022-05);上海市虹口区卫健委第二轮“国医强优”三年行动计划(2022-2024年)立项项目(HKGYQYXM-2022-30)。

摘　　要：介绍曹烨民教授诊治硬皮病性坏疽的临床经验。认为本病病位在“络”,发病特点为“虚、邪、瘀”,治疗上可分为内治法和外治法。内治法分期论治,急性发作期以“清”为要,方选自拟凉血和营方加减以清热凉血、和营通络;好转恢复期治疗上以“养”为主,温清并用,方选自拟扶正清解方加减以扶正化瘀、凉血通络。外治法分阶段论治,以消、托、补贯穿治疗全程,提倡手术宜迟不宜早,使用阶段性、渐进性清创与创面换药等方法建立良好的创面微环境,保护护场,促进创面愈合。并附验案2则。This paper introduces the clinical experience of Professor Cao Yemin in treating scleroderma gangrene(SG),which he identifies as primarily affecting the"collaterals(luo)"and characterized by"deficiency,pathogens and stasis".The treatment can be divided into internal and external therapies.Internal therapy is tailored to the specific phase of the disease.In the acute phase,the primary focus is on"clearing",using modified self-formulated Liangxue Heying Prescription to clear heat,cool the blood,harmonize the nutritive and blood levels,and resolve stasis.During the remission phase,the emphasis shifts to"nourishing",where a combination of warming and clearing methods is used.The treatment prioritizes supporting vital qi,resolving stasis,cooling the blood,and unblocking the collaterals,with modified self-formulated Fuzheng Qingjie Prescription specifically designed for the treatment.External therapy is tailored to the specific stage of the disease,with an emphasis on the principles of elimination,support,and supplementation throughout the treatment process.Surgical intervention is advised to be delayed rather than performed prematurely,allowing for staged and progressive debridement and wound dressing techniques to establish a favourable wound microenvironment,protect the wound and surrounding tissues,and promote healing.Two proven cases are presented for illustration.

关 键 词：硬皮病 坏疽 自身免疫病 内外兼治 名医经验 中医药疗法 

分 类 号：R259[医药卫生—中西医结合] R249[医药卫生—中医内科学]