基于精气学说探析重症肌无力的辨治经验  

Exploring the Differentiation and Treatment Experience of Myasthenia Gravis Based on the Essence-Qi Theory

作　　者：陈晓晴 张爽 袁梦石[2] CHEN Xiaoqing;ZHANG Shuang;YUAN Mengshi(Hunan University of Chinese Medicine,Changsha 410036,China;Department of Neurology,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410036 [2]湖南中医药大学第一附属医院神经内科,湖南长沙410007

出　　处：《延边大学医学学报》2025年第3期125-129,共5页Journal of Medical Science Yanbian University

摘　　要：重症肌无力(MG)是一种自身免疫系统介导的难治性疾病,目前西医尚无明确治愈方法,且药物治疗的耐药性、不良反应及经济压力均不容忽视。袁梦石教授基于精气学说,从“精”“气”的生成、转化过程辨治MG,认为脾肾精气虚损,肌群失养是MG的病机核心;脏虚气郁,内生湿浊痰瘀,胶着难下,是MG病程日久难复的重要因素;肝体失疏,气机失调,精气失布是MG快速进展的关键环节。治疗以温补脾肾、益气生精为本,随证攻补兼施,调控气机,驱邪外出。擅用风药引经,取其宣通、升散之性,以引药上行、调气疏肝、布散精气,协调脾肾肝功能。袁梦石教授基于精气学说辨治MG疗效明显,为临床治疗MG提供了新思路。Myasthenia gravis(MG)is a refractory autoimmune-mediated disease for which Western medicine currently lacks definitive curative methods.Challenges such as drug resistance,adverse reactions,and financial burdens associated with pharmacological treatments cannot be overlooked.Professor YUAN Mengshi,guided by the Essence-Qi Theory,diagnoses and treats MG by analyzing the generation and transformation processes of"Essence"and"Qi."He posits that the core pathogenesis of MG lies in the deficiency of spleen and kidney essence-qi,leading to malnourishment of muscle groups.Additionally,visceral deficiency with qi stagnation,internal accumulation of dampness,turbidity,phlegm,and blood stasis are critical factors contributing to the prolonged and refractory nature of MG.The dysfunction of the liver system,resulting in qi mechanism disorder and impaired essence-qi distribution,is identified as a key driver of rapid disease progression.The treatment strategy emphasizes warming and tonifying the spleen and kidney,replenishing qi and generating essence as the foundation,while dynamically balancing reinforcement and elimination based on syndrome differentiation.Professor YUAN skillfully employs wind medicinals with channel-guiding properties,leveraging their diffusing,ascending,and dispersing characteristics to direct medicinals upward,regulate qi,soothe the liver,distribute essence-qi,and harmonize the functions of the spleen,kidney,and liver.His approach,rooted in the Essence-Qi Theory,demonstrates significant clinical efficacy and offers novel insights for MG management.

关 键 词：重症肌无力 精气学说 脾 肾 肝 风药 

分 类 号：R255.6[医药卫生—中医内科学]