摘要
黄煌教授认为,“风胜则动”为帕金森病发生的基本病机,病位在肝与筋脉,与肺、脾、肾、心等脏关系密切。本病分为痰热生风证、热盛动风证、正虚风中证、阳虚动风证和虚劳化风证五个证型,并根据病程所处的不同阶段分期论治,以“方-病-人”诊疗模式辨其体质精准选方用药。早期以痰热生风证、热盛动风证为主,治宜清热,兼顾化痰、通腑、熄风、镇惊,方选柴胡加龙骨牡蛎汤、风引汤;中期以正虚风中证为主,治宜祛风散邪、益气养血并重,方选续命汤;晚期以阳虚动风证和虚劳化风证为主,治宜温补理虚,兼顾调气行水,方选真武汤、薯蓣丸。黄教授在临证施治过程中治风却不拘泥于熄风,求其生风之本、风中之因,切合病机,随证化裁,还注重调整体质偏颇,从整体上平衡阴阳、调畅气机、调和脏腑,辨体质分阶段治疗帕金森病,效如桴鼓。
Professor Huang Huang believes that the basic pathogenesis of Parkinson′s disease is(PD) "predominate wind causing motion",the disease is located in the liver and muscles,and is closely related to the viscera such as the lung,spleen,kidney and heart,etc.PD is divided into five syndromes:syndrome of phlegm-heat inducing wind,syndrome of excessive heat stirring wind,syndrome of deficient healthy qi causing wind attack,syndrome of yang deficiency stirring wind,and syndrome of consumptive disease transforming into wind.According to the different stages of the course of the disease,he adopts the "formula-disease-patient" diagnosis and treatment model to identify the constitution for precise selection of formula and medication.In the early stage,syndrome of phlegm-heat inducing wind,syndrome of excessive heat stirring wind are the main symptoms.The treatment should focus on clearing heat,resolving phlegm,dredging fu-organs,eliminating wind,and calming fright,so Bupleurum and Os Draconis and Oyster Shell Decoction,Wind-Inducing Decoction can be used.In the middle stage,syndrome of deficient healthy qi causing wind attack is the main factor.The treatment should focus on dispelling wind and removing pathogens,supplementing qi and nourishing blood together,so Life-Prolonging Decoction can be used.In the late period,syndrome of yang deficiency stirring wind;syndrome of consumptive disease transforming into wind are the main syndromes.The treatment should focus on warm tonifying deficiency,t regulating qi and promoting urination,so True Warrior Decoction and Rhizoma Dioscoreae Pills can be selected.In the process of clinical treatment,Professor Huang is not strictly in eliminating wind,but seeking the root cause of generating wind and wind attack,conforms to the disease mechanism to adopt syndrome differentiation.He also pays attention to adjusting the bias of the constitution,regulating the whole balance of yin and yang,and qi movement,harmonizing the viscera,distinguish the physical constitution and staged treatment of P
作者
常美如
张静艺
骆守真
郑艳
CHANG Meiru;ZHANG Jingyi;LUO Shouzhen;ZHENG Yan(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210023)
出处
《河南中医》
2024年第7期1049-1054,共6页
Henan Traditional Chinese Medicine
基金
2022年国家中医药管理局第五批全国中医临床优秀人才研修项目{国中医人教函【2022】1号}
国家中医药管理局第四批全国中医(西学中)优秀人才研修项目{国中医药人教发[2019]13号}
全国名中医传承工作室建设项目{国中医药办人教函[2022]245号}
深圳市“医疗三名工程”资助项目(SZZYSM202208011)。
关键词
帕金森病
“风胜则动”
“方-病-人”
分期论治
辨体质
痰热生风证
热盛动风证
正虚风中证
阳虚动风证
虚劳化风证
黄煌
Parkinson′s disease(PD)
"predominate wind causing motion"
"formula-disease-patient"
staged treatment
differentiation of physical constitution
syndrome of phlegm-heat inducing wind
syndrome of excessive heat stirring wind
syndrome of deficient healthy qi causing wind attack
syndrome of yang deficiency stirring wind
syndrome of consumptive disease transforming into wind
Huang Huang
