金实“易化”辨治思维在风湿性疾病中的运用  

Application of“Simplifying”Syndrome Differentiation Thinking of JIN Shi in Rheumatic Diseases

作　　者：周龙云 陈旭青[2] 李建 方露 金实(指导)[2] ZHOU Longyun;CHEN Xuqing;LI Jian;FANG Lu;JIN Shi(The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院,江苏南京210029 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《辽宁中医杂志》2024年第12期19-22,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学青年科学基金项目(82205148,81804152);全国名老中医药专家金实传承工作室建设项目(国中医药人教发〔2016〕42号);江苏省名老中医药专家金实传承工作室建设项目(苏中医科教〔2016〕6号)。

摘　　要：风湿性疾病的临床诊治甚为复杂,如何在临证时简明、清晰地应对此类复杂、疑难疾病,是医者颇为关注的问题之一。金实教授对杂难病证论治经验颇丰,在了然百家经典,临证思辨历久升华中,金老为繁杂的风湿性疾病构建了一套“主翼方略结合”剖析式的辨治思维模式。文章则从“IgA血管炎”“类风湿关节炎”“强直性脊柱炎”三大临床常见风湿性疾病,窥探金老构建的“易化”辨治思维。金老认为广博诸病论识,径取干要,以求病候之本源,此理之“易”也;诸病虽异,然均内涵主线规律,并兼旁流之论,据此制定“主体策略结合翼展方案”总法则,此法之“易”也;立于具体病候之主线规律,结合个体之变,有序落定主干方药及翼展方案,此方之“易”也。理、法、方之“易化”,临证思绪自然分明矣。The diagnosis and treatment of rheumatic diseases is complicated,a important challenge in clinic is how to concisely and clearly deal with such complicated and difficult diseases.Professor JIN Shi is equipped with a lot of experience in the treatment of complicated diseases.In basis of abundant knowledge regarding hundreds of classics,long-term practice and repeated refinement,professor JIN Shi constructs a“main strategy combined with wingspan plan”thinking of syndrome differentiation and treatment mode for the treatment of rheumatic diseases.It illustrated the application of“simplifying”thinking of syndrome differentiation and treatment of professor JIN Shi by analyzing the“IgA vasculitis”,“rheumatoid arthritis”and“ankylosing spondylitis”.Professor JIN Shi suggests studying huge amount of knowledge of various diseases and acquiring the main line of diseases through repeated refinement,which is the“simplification”in theories.Although the diseases are different,they all contain the main line law and the theory of side flow.Based on this,it formulates the“main strategy combined with wingspan plan”mode which is the“simplification”in methods.Finally,according to the main line rule of specific diseases and individual changes,it then orderly determines the main prescriptions and wingspan drugs which is the“simplification”in recipes.The“simplification”in the theory,method and recipe endows the clinical thoughts naturally and clearly.

关 键 词：金实 IgA血管炎 风湿关节炎 强直性脊柱炎 易化 辨治思维 

分 类 号：R25[医药卫生—中医内科学]