摘要
本文以伤寒六经辨证为切入点,以方证路径为导向,总结蒋开平教授论治乙型肝炎的学术经验。急性乙型肝炎或慢性乙型肝炎急性发作者,在太阳病经证、腑证、兼证、变证中寻觅相应的方证;病情持续进展为里热实证者,可仿阳明病论治,并区分实证、热证、变证而择选相应的方剂;病情慢性化进程中表现为“相火上炎,枢机不利”者,则按少阳病论治,并因兼表、兼里、兼水饮之不同而针对性选方;病从寒化而为太阴病者,基于太阴病的病机特点而借用方剂;病情发展为重症乙型肝炎出现伤阳、耗阴之象者,可从少阴病论治,并因寒化、热化、兼变之不同而重点选方;难治性患者或抗病毒治疗耐药患者,出现寒热虚实错杂时,可从厥阴病论治中寻求突破点。
Based on six channels of syndrome differentiation of Treatise on Febrile Disease and guided by the path of Fang Zheng,this paper summarizes Professor Jiang Kaiping′s academic experience in treating hepatitis B.Patients with acute hepatitis B or acute attack of chronic hepatitis B were searching for the corresponding prescription syndromes among the meridian syndromes,fu-organ syndromes,accompanied syndromes and deteriorated syndromes of Taiyang disease.If the disease progresses continuously to"interior excess and heat syndrome",it can be treated by imitation of Yangming disease theory,and choosing the corresponding prescription by distinguishing sthenia,heat,and deteriorated syndrome.In the chronic process of the disease,the symptoms of"ministerial fire on inflammation,the perspective of the dysfunction",according to Shaoyang disease treatment,and because of the difference between the outside,the inside,and the retained fluid choose the prescription.The patients whose disease changed from cold to lunar disease choose prescriptions based on the pathogenesis of lunar disease.If the disease progresses to severe hepatitis B,the symptoms of Yang injury and Yin depletion can be treated from Shaoyin disease,and the prescription should be selected mainly because of the difference of cold,heat,and concurrent change.The breakthrough point can be found in the treatment of Jueyin disease when the refractory patients or the patients resistant to antiviral therapy appear a mixture of cold,heat,weakness,and obstruction.
作者
刘重麟
蒋开平
LIU Zhong-lin;JIANG Kai-ping(Foshan Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Chinese Medicine,Guangdong Foshan,528000,China)
出处
《中西医结合肝病杂志》
CAS
2024年第1期1-4,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
第六批全国老中医药专家学术经验继承工作项目(国中医药人教发〔2017〕29号)。
关键词
伤寒论
六经辨证
方证
乙型肝炎
treatise on febrile disease
syndrome-differentiation of the six meridians
formula and syndrome
hepatitis B
