王莒生老师学术思想与临床经验总结及浮楮清热除湿汤治疗急性湿疹的临床研究

发布时间：2017-12-27 09:49

本文关键词：王莒生老师学术思想与临床经验总结及浮楮清热除湿汤治疗急性湿疹的临床研究　出处：《北京中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：自2012年我荣幸成为全国老中医药专家王莒生的学术经验继承人,在三年的跟师学习过程中,结合王老师的耐心讲解及自身感悟,我深刻体会到老师在临床中的治病理念与诊疗技巧,较全面的总结出王老师的学术思想和临床经验。王莒生老师是首都医科大学附属北京中医医院皮科主任医师,国家级名老中医,全国第四、五批老中医药专家学术经验继承指导老师,享受国务院政府特殊津贴。在几十年的行医生涯中,累积了丰富的临床经验,擅长治疗白癜风、湿疹、银屑病、荨麻疹、痤疮等皮肤科常见病。对于内科呼吸道疾病、老年性便秘等疾病的防治也有着自己独特的观点；对于儿科皮肤病、呼吸道疾病等也颇有研究。王莒生老师的学术思想主要受赵炳南和关幼波等中医专家影响,一是“药疗”与“话疗"相结合的中医治疗整体观,讲究诊病时药物治疗与心理疏导相结合,真正做到整体治疗；二是“肝肺同治”治疗皮肤病的治疗观；三是内科杂病及疑难杂症“从肝论治"的思想。临床经验总结方面,我系统总结了王老师治疗湿疹、白癜风、银屑病、荨麻疹、痤疮、慢性咳嗽、老年性便秘等疾病的经验,归纳整理了老师特色的治疗方法和学术思想,总结了老师在药物应用及方剂使用方面的特色,着重介绍了能体现老师学术价值的代表方剂和常用药物的使用经验。本文的主要内容分为三大部分：一、王莒生老中医药专家学术渊源王莒生老师提倡尊崇经典,融会新知。推崇《黄帝内经》的养生理念；善用《伤寒论》、《金匮要略》的经典方剂治疗疾病,主张“古方今用”；在学习经典的基础上,积极吸取现代医学成果,从各种疾病的最新治疗指南到中药药理学新进展,靡不涉猎。王莒生老师曾师从我院多名中医大师,其中医学术特点的形成与其工作经历息息相关。王老师从科研及门诊两方面与各位名老中医进行学习,继承并发扬了他们的学术思想及临床经验,内科治疗尊崇关幼波老师气血辨证理论,与八纲辨证相结合,形成“十纲辨证”法,重视”从肝论治”,应用于多种疾病的辨证治疗中。皮肤病诊治思想深受皮科泰斗赵炳南先生影响,效法赵老外病内治思想,善于外病内治,整体治疗,并提出“肝肺同治”,在皮肤病治疗中发挥了重要的作用。呼吸病深受许公岩、滕宣光、林杰豪、曹希平等人的学术思想影响,强调痰湿是咳喘病久治不愈的重要内因,主张治咳喘重在明确咳喘与五脏的关系,从脏腑失衡方面入手进行治疗。儿科受温振英老中医影响,推崇补益气阴,并将这一治疗理念运用到许多儿科疾病的治疗当中。二、学术思想主要特点1.“药疗”与“话疗”相结合的中医治疗整体观王莒生老师从整体观念出发,辨证时既重视当前病证,又重视全面观察分析与现病证相关的其他病证及隐患。论治时紧抓根本,在考虑解决主要症状的同时,对其他病证适当兼顾。她认为真正的医学模式应该是与社会、环境、身心相关的模式,讲究诊病时药物治疗与心理疏导相结合,真正做到整体治疗,并用于指导临床治疗。2.皮肤类疾病应“肝肺同治”的思想王莒生老师认为皮肤病虽发于外,但常常与内脏有着密切的关系。尤其是与“肺”、“肝”二脏的关系密切,一方面“肺主皮毛”,空气污染等外在因素直接影响到皮肤病变；另一方面社会压力增大,导致患者肝气不舒,加之皮肤病常常反复发作,干扰患者的日常生活,常致肝郁,因此“疏肝理气”、“开肺窍”是王莒生老师治疗皮肤科疾病的重要的学术思想。3.“从肝论治”治疗内科杂病及疑难杂症的思想临床诊治内科杂病时,王莒生老师尤其强调“疏肝”的重要性,诊病施治时,时时注重对肝脏的调理,其重视“疏肝”的思想不仅要体现在皮肤科病证的诊治方面,在内科其它各种疾病的诊治过程中,也需贯彻这一思想,故在临床中立足“疏肝”,论治多种疾病,往往取得意想不到的效果。4.临床经验主要特点系统总结王老师治疗湿疹、白癜风、银屑病、荨麻疹、痤疮、慢性咳嗽、便秘等疾病的经验,归纳整理了老师特色的治疗方法和学术思想,总结了老师在药物应用及方剂使用方面的特色,着重介绍了能体现老师学术价值的代表方剂和常用药物的使用经验。三、专病研究通过临床试验反映王莒生老师治疗湿疹的学术思想及经验特色为开肺窍；王老师运用浮楮清热除湿汤治疗急性湿疹的机理在于该方药可以通过细胞因子白介素的调节对急性湿疹进行治疗,临床试验发现该方剂对细胞因子IL-2、IL-4、INF-γ有一定的干预作用,有望找到中药治疗该疾病的靶点所在,有待进一步研究证实。
[Abstract]:Since 2012, I have the honor to become the national old TCM expert Wang Jusheng's academic experience inheritance, learning with the teacher in the course of three years, according to Wang's own feeling and patience to explain, I deeply appreciate the teacher in the clinical treatment and treatment concept of comprehensive skills, and the academic thought and clinical experience of the king the teacher. Mr. Wang Jusheng is the chief physician of the Department of Dermatology of Beijing Chinese Medicine Hospital affiliated to Capital Medical University. He is a national famous veteran doctor of traditional Chinese medicine. He is the fourth, fifth batch of veteran doctors of traditional Chinese medicine who inherits the academic experience, and he enjoys the special allowance of the State Council. In the decades of medical career, accumulated rich clinical experience, good at the treatment of vitiligo, eczema, psoriasis, urticaria, acne, and other common diseases in the Department of dermatology. It also has its own unique views on the prevention and treatment of respiratory diseases, senile constipation and other diseases. For pediatric dermatology, respiratory diseases and so on, there are also some researches. Professor Wang Jusheng's academic thought mainly by Zhao Bingnan and Guan Youbo and other Chinese experts, one is "medication" and "talk therapy" treatment of traditional Chinese medicine combining whole concept, pay attention to diagnosis when drug therapy and psychological counseling combined with truly holistic treatment; two is "treatment of liver and lung with the treatment of skin diseases; three miscellaneous diseases and Difficult miscellaneous diseases" from the liver "thought. To summarize the clinical experience, I summarized the teacher Wang treatment of eczema, vitiligo, psoriasis, urticaria, acne, chronic cough, constipation and other diseases, induction treatment and finishing the teacher academic thought characteristic, summarizes the characteristics of the teacher use in drug application and prescription, emphatically introduces the experience to reflect the use of teacher academic value and representative prescription drugs. The main contents of this article are divided into three parts: 1. The academic origin of Wang Jusheng's old Chinese medicine expert, Wang Jusheng, advocates respecting the classics and integrating new knowledge. The idea of "the respected" Yellow Emperor; the use of "typhoid fever", "Golden Chamber" of the classic prescription for treating diseases, advocates of "ancient means"; on the basis of classical learning, and actively absorb the achievement of modern medicine from various diseases to the latest guidelines for the treatment of Chinese medicine pharmacology progress doesn't dabble. Mr. Wang Jusheng had been a master of traditional Chinese medicine from our hospital. The formation of the academic characteristics of traditional Chinese medicine was closely related to its work experience. Mr. Wang from the two aspects of scientific research and clinic with all the old Chinese medicine to learn, inherit and carry forward the academic thought and clinical experience of their medical treatment, respect the teacher acted off syndrome differentiation of Qi and blood theory, combined with the eight principal syndromes, the formation of "ten Gang syndrome", "attention from the liver, syndrome differentiation and treatment application in a variety of diseases in. Skin disease diagnosis thinking by the dermatology Dean Mr. Zhao Bingnan, according to Zhao foreigner within the disease, good within the disease, overall treatment, and put forward the "liver lung Tongzhi", played an important role in treating skin diseases. Influence of the academic thoughts of respiratory disease by Xu Gongyan, Teng Xuanguang, Lin Jiehao, Cao Xiping et al., stressed that phlegm is an important internal cause of asthma treatment, cure cough cough is clear that the relationship with the five internal organs, starting from the treatment of viscera imbalance. Under the influence of Wen Zhenying's old Chinese medicine, paediatrics praised the nourishing Qi Yin, and applied this treatment to the treatment of many pediatric diseases. Two, the overall treatment of traditional Chinese medicine academic thought of 1. main features of "medication" and "talk therapy" combined with the concept of Teacher Wang Jusheng starting from the overall concept, the disease not only pay attention to differentiation, and the importance of comprehensively observed and analyzed other diseases and disease related risks. The treatment has to simply solve the main symptoms in consideration at the same time, the appropriate balance of other diseases. She thought that the true medical model and pattern is related to social, environmental, physical and mental stress, when the diagnosis of drug treatment and psychological counseling combined with truly holistic therapy, and to guide the clinical treatment. 2. the thought of "liver and lung Tongzhi" thought by Wang Jusheng thought that although the skin disease was sent out, it often had a close relationship with the viscera. Especially with the "lung" and "liver" two dirty close hand "lung advocate fur, air pollution and other external factors directly affect the skin lesions; on the other hand, the social pressure increases, resulting in patients with stagnation of liver qi, and skin disease often repeated attacks, interfere with the patient's daily life, often caused by stagnation of liver Qi therefore, the" liver qi "and" open pulmonary orifices "is Professor Wang Jusheng in the treatment of diseases in Department of Dermatology of important academic thought. 3. "from the liver" in the treatment of miscellaneous diseases and Difficult miscellaneous diseases thought clinical diagnosis and treatment of internal diseases, Professor Wang Jusheng with particular emphasis on the importance of the diagnosis of liver "treatment, pay attention to conditioning on liver, its emphasis on" liver "thought not only to reflect the diagnosis and treatment of diseases in Department of Dermatology, in the process of other kinds of medicine the diagnosis and treatment of the disease, also need to implement this idea, it is based on the" liver "in clinical practice, the treatment of various diseases, often have unexpected effects. Summary of Teacher Wang treatment of eczema, vitiligo, psoriasis, urticaria, acne, chronic cough, constipation and other diseases the main characteristics of the system of 4. clinical experience experience, summed up the treatment method and the academic thought of finishing the teacher characteristics, summarizes the characteristics of teacher use in drug application and prescription, emphatically introduces the experience of using the teacher can reflect the representative prescription the academic value and commonly used drugs. Three, special disease research through clinical trials to reflect the academic thought and experience in treating eczema Wang Jusheng teacher open lung Qiao Wang; mechanism of treating acute eczema with floating mulberry Qingre Chushi decoction is the recipe can by regulating cytokine interleukin on the treatment of acute eczema, clinical trials found the prescription on cells
【学位授予单位】：北京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R275.9

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