高建忠论治耳鸣临证经验拾萃  

GAO Jianzhong's clinical experience in treating tinnitus

作　　者：赵焱 张晓阳 赵玉君 樊艳 丁喜英 张浩 高建忠 ZHAO Yan;ZHANG Xiaoyang;ZHAO Yujun;FAN Yan;DING Xiying;ZHANG Hao;GAO Jianzhong

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省中西医结合医院,山西太原030013

出　　处：《中医临床研究》2024年第30期53-57,共5页Clinical Journal Of Chinese Medicine

摘　　要：耳鸣具有高发病率和低治愈率,已经成为耳鼻喉科常见的三大难题之一。耳鸣病因复杂,西医常采用改善耳内微循环和营养神经、扩充血管等药物治疗或配合高压氧治疗。中医药治疗耳鸣可以减轻患者症状、提高其生活质量,疗效显著。高建忠主任从事临床工作近30载,精研医理,勤于临证,深受张机(字仲景)和易水学派思想影响,临床上详辨外感、内伤,用药细腻灵活,治病先后有序,形成了富有战略思维的中医临证诊疗体系。笔者跟师日久,习察老师治疗耳鸣用药灵活,颇有心得。高师认为其根本在脾肾,发病关键在于机体气血阴阳失衡、脏腑气机失调。治疗方面基于战略思维,首辨外感、内伤,对于外感病,治以解表利窍;对于内伤病,讲究先后次序:先恢复机体气血阴阳的平衡以及脏腑之间的协调,或调气和血,或恢复清升浊降,或疏肝解郁,待其血气调和,脏腑气机协调,升降有序,再予以健脾补肾,缓缓过渡,进一步收功。常以自拟“麻附辛蝉蚕葶方”、血府逐瘀汤、益气聪明汤、温胆汤、逍遥散、自拟“解郁方”、四君子汤作为基础方,酌情加减,临床用之,疗效颇佳。文章一方面意在介绍高老师治疗耳鸣的临证经验,一方面以耳鸣一病的论治举例阐述战略思维在中医临证中的重要性。文章中附验案1则,以期为临床相关治疗提供参考。With its high incidence and low cure rate, tinnitus has become one of the three common problems in otolaryngology. The cause of tinnitus is complex, and Western medicine often uses drugs to improve the microcirculation in the ear and nutrition nerve, expand blood vessels, or combines with hyperbaric oxygen therapy. Traditional Chinese medicine treatment of tinnitus can reduce the symptoms of patients, improve their quality of life, and the effect is remarkable. Director GAO Jianzhong has been engaged in clinical practice for nearly 30 years, has a profound understanding of medical principles and is diligent in clinical practice. The director has been deeply affected by the thought of ZHANG Ji and Yishui School. In clinical practice, the director carefully differentiates the exogenous and endogenous pathogenic factors and applies drugs delicately and flexibly. The director treats diseases in a logical sequence, and has formed a TCM diagnosis and treatment system with rich strategic thinking. The author has followed the teacher in clinic for a long time, has observed the teacher's flexible medication and treatment on tinnitus, and has been inspired a lot. Mentor GAO believes that the root of the disease lies in the spleen and kidney, and the key lies in the imbalance of Qi( 气)-blood and Yin( 阴)-Yang( 阳) of the body and the imbalance of viscera. The treatment is based on strategic thinking, the first is to differentiate the external and internal injuries, for external diseases, the treatment is to relieve the exterior and benefit the orifice;for internal injuries, attention should be given to the order: firstly, to restore the balance of Qi-blood and Yin-Yang and the coordination between the viscera by regulating Qi and blood, or restoring ascending of Qi and descending of turbidity, or soothing the liver to relieve depression;After achieving the blood and Qi harmony, viscera Qi coordination, orderly ascending and descending, the spleen and kidney are strengthened to achieve slow transition and further effects

关 键 词：耳鸣 战略思维 临证经验 

分 类 号：R276.1[医药卫生—中医五官科学]