摘要
孙达武教授认为,急性骨萎缩的病因不外乎内外两因,内因责之于肝脾肾三脏亏虚,气血不足,外因在于外邪伤其经络筋骨。急性骨萎缩以虚为本,以瘀为标,主要病机为肝肾亏虚,促进因素为脾失运化,病理产物为瘀血。孙教授将急性骨萎缩急性期、营养障碍期辨证为气滞血瘀证,以祛瘀为主,行气活血、通络止痛,兼以扶正;萎缩期辨证为肝肾亏虚证,以扶正补虚为主,补肝健脾益肾,兼以祛邪。另外,孙教授认为,瘀血的形成有气血虚实之不同,瘀血的部位有内外上下之差异,故早中期用药以“破”为主,后期用药以“补”为主,治疗原则为活血化瘀、和血生新、补气养血。孙教授针对急性骨萎缩的早中期,内用自拟活络止痛方,外用海桐皮汤加减,内外药物合用,相辅相成。此外,孙教授临证用药擅用黄芪、当归气血双补,还提出“脾肾并重”的思想,对急性骨萎缩患者采用脾肾双补法,常以熟地黄、山茱萸、山药三药联用。
Professor Sun Dawu believes that the etiology of acute bone atrophy is nothing more than internal and external causes.The internal causes are due to deficiency of the liver,spleen and kidney,and the insufficiency of qi and blood,while the external causes are due to the injury of meridians and muscles attacked by external pathogens.Acute bone atrophy has deficiency as the root cause and blood stasis as the manifestation.The main pathogenesis is liver-kidney deficiency.The promoting factor is the spleen failing to transport and transform,and the pathological product is blood stasis.Professor Sun differentiates the acute phase and nutritional disorders stage of acute bone atrophy as qi stagnation and blood stasis syndrome,so he mainly focuses on eliminating blood stasis to move qi and activate blood circulation,activate channels and relieve pain,and to strengthen healthy qi.The atrophy phase is liver-kidney deficiency syndrome,the treatment mainly focuses on strengthening healthy qi and tonifying deficiency to nourish the liver,invigorate the spleen and nourish the kidney,and to eliminate pathogens.In addition,Professor Sun also treats acute bone atrophy from blood stasis,believes that the formation of blood stasis has differences in qi,blood,deficiency and excess,and the location of blood stasis has differences in up and down.inside and outside.Therefore,the early and middle stage of drug use is mainly for"breaking",and the late stage of drug use is mainly for"nourishment".The principle of treatment is to activate blood and remove stasis,harmonize blood and renew blood,nourish qi and blood.In the early and middle stages of acute bone atrophy,Professor Sun uses his self-made Channel-Activating and Pain-Relieving Formula for internal use,and Modified Haitongpi Decoction for external use,complementing each other.In clinical practice,he often uses Huangqi(Radix Scutellariae)and Danggui(Radix Angelicae Sinensis)to replenish both qi and blood.He has proposed the idea of"paying equal attention to spleen and kidney".For pa
作者
叶心雨
孙绍裘
YE Xinyu;SUN Shaoqiu(Hunan University of Chinese Medicine,Changsha,Hunan,China,410208;The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China,410005)
出处
《河南中医》
2024年第6期861-866,共6页
Henan Traditional Chinese Medicine
基金
湖南省中医骨伤临床医学研究项目(2020SK4013)。
关键词
急性骨萎缩
急性期
营养障碍期
萎缩期
气滞血瘀证
肝肾亏虚证
活络止痛方
海桐皮汤
孙达武
acute bone atrophy
acute stage
nutritional disorders stage
atrophy stage
qi stagnation and blood stasis syndrome
liver and kidney deficiency syndrome
Channel-Activating and Pain-Relieving Formula
Haitongpi Decoction
Sun Dawu
