蔡瑞康教授中西医结合治疗白癜风学术思想与临床研究

发布时间：2018-04-26 18:50

本文选题：白癜风 + 白驳汤　；参考：《中国人民解放军军医进修学院》2008年博士论文

【摘要】： 蔡瑞康教授从事中西医结合皮肤科临床工作50余载,勤求古训,博采众长,立法遣方,灵活善用,积累了丰富的临床经验。他在临床工作中结合现代医学进畏,将中医与西医两种诊疗体系有机结合,提出了皮肤病中医辨证与西医辨病相结合的诊治理论,中西医结合治疗白癜风、皮炎、湿疹、银屑病、痤疮等常见的皮肤病,效果显著,享誉全国。白癜风是一种临床常见的慢性获得性色素脱失性皮肤病,发病率1%～2%,治疗方法虽多,但起效慢、疗程长、治愈率低,是皮肤科顽症之一。蔡教授认为本病的病因病机是由肝肾不足、气血不和、气滞血瘀所致;治法以滋补肝肾、调和气血、活血化瘀为主,同时重视情志因素的致病作用,辅以疏肝理气解郁药物,精心研制出经验专方“白驳汤”。本课题通过采用皮肤镜、皮肤图像分析系统、皮肤颜色测量仪等现代医学观测方法进行形态学观察和客观测量,研究导师白驳汤中医西结合治疗白癜风的临床疗效及辨治思想。结果证实,结果证实,(1)白驳汤中西医结合组起效快,各时间段总体疗效均明显优于单纯西医治疗组,并且随治疗时间的增加白驳汤方显示了更佳的疗效;(2)两组白斑的色素恢复的过程都是渐进的,疗效与治疗时间的程正相关性,说明对于白癜风这种慢性难治性皮肤病,应强调坚持连续治疗的重要性,疗程长是该病的治疗特征之一;(3)疗效观测指标可以量化,比以往的临床单纯感官判断更加敏感和客观。皮肤镜及图像分析技术可观察到毛囊周围出现的色素点和毛细血管充血扩张等白斑早期复色迹象;(4)白癜风发病和加重与精神因素密切在本次研究中得到证实,让患者及时了解到疗效进步,并在中医理论指导下辅以疏肝理气解郁调治,有助于减轻患者精神压力、增加治疗信心、配合医生完成治疗,进而提高总体疗效。本课题还通过对门诊120例白癜风患者进行心理问卷调查、心理干预和分组检验,目的是判断心理干预在白癜风治疗中的作用。结果表明,心理干预治疗对于白癜风治疗确有辅助增加疗效的作用,并有助于提高疗效和患者的生活质量。本人在攻读中医师承制博士学位期间,经蔡教授悉心指导,系统地学习了皮肤病治疗的中西医理论,跟师参加临床实践,切身体会到导师的高尚医德和勤奋钻研精神;感悟到中西合璧、融会贯通、开拓进取,走中西医结合之路是其皮肤病治疗的学术特点和灵魂。在本课题的设计、实施、总结等全过程中,导师言传身教,严格要求,使我在中西医结合在专业理论水平和实际运用能力方面获得巨大的进步,今后将更加自觉地学习和继承导师累积的丰富临床经验,为祖国中西医结合治疗皮肤病事业做出贡献。
[Abstract]:Professor Cai Ruikang is engaged in the clinical work of integrated traditional Chinese and western medicine for more than 50 years. He has accumulated rich clinical experience. In his clinical work, he combined modern medicine with modern medicine and organically combined the two systems of diagnosis and treatment of traditional Chinese medicine and western medicine, and put forward the theory of diagnosis and treatment of skin diseases based on TCM differentiation of symptoms and signs and differentiation of diseases in western medicine. The treatment of vitiligo, dermatitis, eczema with combination of traditional Chinese and western medicine, Psoriasis, acne and other common skin diseases, remarkable effect, renowned throughout the country. Vitiligo is a common chronic acquired pigment loss dermatosis. The incidence of vitiligo is 1 and 2. Although there are many methods of treatment, the course of treatment is slow, the course of treatment is long, and the cure rate is low. It is one of the intractable dermatological diseases. Professor Cai believes that the etiology and pathogenesis of this disease are caused by deficiency of liver and kidney, disharmony between qi and blood, and stagnation of qi and blood stasis. The treatment is mainly by nourishing the liver and kidney, harmonizing qi and blood, activating blood circulation and removing blood stasis. At the same time, he attaches importance to the pathogenicity of emotional factors and adjusts drugs to soothe liver and regulate qi and relieve depression. Carefully develop the experience of the special prescription, "White Mottage Tang". By using modern medical observation methods such as dermoscope, skin image analysis system and skin color measuring instrument, this paper studies the clinical curative effect and the thinking of differentiation and treatment of vitiligo treated by the combination of traditional Chinese medicine and western medicine. The results showed that the effect of the combined traditional Chinese and western medicine group was faster, and the overall curative effect of each time period was obviously better than that of the pure western medicine treatment group. And with the increase of the time of treatment, the decoction shows a better curative effect.) the process of pigment recovery of the two groups of white spots is gradual, and the effect is positively correlated with the duration of treatment, which shows that the treatment of vitiligo is a chronic and refractory skin disease. It should be emphasized that the importance of continuous treatment should be emphasized. The long course of treatment is one of the characteristics of the treatment of the disease. The observation index of curative effect can be quantified, and it is more sensitive and objective than the clinical simple sensory judgment in the past. Dermoscopy and image analysis techniques can be used to observe pigment spots around hair follicles and signs of early coloration of white spots, such as hyperemia and dilation of capillaries. (4) Vitiligo is closely related to mental factors and the pathogenesis and aggravation of vitiligo is confirmed in this study. It is helpful to lighten the patients' mental pressure, increase their confidence in the treatment, cooperate with the doctors to complete the treatment, and then improve the overall curative effect under the guidance of the theory of traditional Chinese medicine. The purpose of this study was to judge the role of psychological intervention in the treatment of vitiligo by psychological questionnaire, psychological intervention and group test in 120 patients with vitiligo. The results showed that psychological intervention could increase the curative effect and improve the quality of life of patients with vitiligo. During my study of doctor of Chinese medicine, I studied the theory of traditional Chinese medicine and western medicine systematically under the guidance of professor Cai, and took part in clinical practice with my teacher. I experienced the noble medical ethics and diligent research spirit of my mentor. It is the academic characteristic and soul of skin disease treatment to realize the combination of Chinese and western medicine, to integrate Chinese and western medicine, to forge ahead and to take the road of integration of traditional Chinese and western medicine. In the whole process of designing, implementing and summing up this subject, my tutor has made great progress in the professional theory level and practical application ability of integrating traditional Chinese and Western medicine with strict requirements. In the future, we will learn more consciously and inherit the rich clinical experience accumulated by our mentors, and contribute to the cause of integrated traditional Chinese and western medicine in the treatment of skin diseases.
【学位授予单位】：中国人民解放军军医进修学院
【学位级别】：博士
【学位授予年份】：2008
【分类号】：R758.410.58;R249

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