柏树纲教授运用“通消清补”四法治疗消化性溃疡的经验总结

发布时间：2018-05-09 05:32

本文选题：消化性溃疡 + 柏树纲教授　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：消化性溃疡(PU)是临床消化系统中较为常见的一类疾病,全球人群发病率为10-12%,其以病程长且反复发作为临床特点,本病以上腹痛为典型症状。目前为止尚未明确论述本病病因及发病机理。近年来西医对检出幽门螺旋杆菌病患进行三联、四联疗法治疗,无幽门螺旋杆菌病患广泛应用胃粘膜保护剂及PPI类药物以减少胃酸分泌、保护胃粘膜治疗,目前临床消化性溃疡治疗愈合率有所提升,但溃疡愈合质量尚不理想,且不良反应多,复发率高。根据症状将本病归属中医学“胃脘痛”,中医治疗本病具有大量经验,值得临床医生总结研究,中医辨证施治优势明显。吾师柏树纲教授熟读经典,精于临床,师承国医大师周学文教授,基于国医大师李玉奇教授、周学文教授的理论和实践经验,对本病病因、病机、辨证、舌诊、治法及组方遣药有着独到见解,尤其重视运用“通消清补”四法治疗本病。本文通过对导师于门诊治疗本病患者的经验进行整理分析,旨在梳理总结本病的病因病机、辩证思想、治疗法则等。本文章第一部分是正文,正文包含前言、经验论述,本文章的前言简单介绍消化性溃疡。经验论述部分对吾师于临床治疗本病过程的临床经验进行总结。吾师提出PU发病“三因学说”即毒热、胃弱脾虚、邪实正虚的病因。引起“毒热”袭胃;胃气不和,气机失调及邪实正虚,虚实错杂致病。故而该病应针对病因灵活运用“通消清补”四法以组方遣药。这为指导临床治疗PU提供一定的理论依据。本文是在导师柏树纲教授的悉心指导下,对导师在门诊治疗PU患者的临证经验进行系统的研究与总结(如发病诱因、病程、辨证分型、用药特点等),于本文章之后举经典病历一则,更以具体的表达柏树纲教授对本病之治疗经验。于治疗本病过程中,针对本病致病“三因”,运用“通消清补”四法为主指导用药,治疗本病效果较好,具有临床指导意义。本文章第二部分是附录,附录主要部分为文献综述,分别从中医及西医的诊疗方面进行论述。
[Abstract]:Peptic ulcer (PUU) is a common disease in the clinical digestive system. The global incidence rate is 10-12. The disease is characterized by long course of disease and repeated attacks, and abdominal pain above the disease is a typical symptom. So far, the etiology and pathogenesis of the disease have not been clearly discussed. In recent years, Western medicine has been used to treat patients with Helicobacter pylori by triple therapy and tetralogy therapy. Patients without Helicobacter pylori are widely treated with gastric mucosal protectors and PPI drugs to reduce gastric acid secretion and protect gastric mucosa. At present, the healing rate of peptic ulcer has been improved, but the quality of ulcer healing is not ideal, and there are many adverse reactions and high recurrence rate. According to the symptoms, this disease belongs to the traditional Chinese medicine "epigastric pain", Chinese medicine treatment of this disease has a lot of experience, it is worthy of clinical doctors to sum up the study, TCM syndrome differentiation and treatment advantages. Professor Bo Shugang, my teacher, is familiar with the classics and is good at clinical practice. Professor Zhou Xuewen is a master of Chinese medicine. Based on the theoretical and practical experience of Professor Li Yuqi and Professor Zhou Xuewen, he has a good understanding of the etiology, pathogenesis, syndrome differentiation and tongue diagnosis of the disease. Treatment and prescription have unique views, especially pay attention to the use of "Tongxiaobingbu" four methods for the treatment of this disease. In this paper, the author analyzes the experience of the tutor in the treatment of this disease in order to sum up the etiology, pathogenesis, dialectical thought, treatment principles and so on. The first part of this article is the main body, the text contains foreword, experience exposition, the preface of this article introduces peptic ulcer briefly. In the part of experience discussion, we summarize the clinical experience of our teacher in the course of clinical treatment of this disease. Our teacher put forward the theory of "three causes" of pu, that is, toxic heat, stomach weak spleen deficiency, and evil deficiency. Causes "toxic heat" to attack the stomach; stomach qi disharmony, Qi-qi disorder and the deficiency of evil, mixed-up pathogenic. Therefore, the disease should be flexible to use the "Tongxiaobing Buu" four methods in order to form prescriptions. This provides a theoretical basis for clinical treatment of pu. This paper is a systematic study and summary on the clinical experience of the tutor in the treatment of pu patients (such as inducement, course of disease, syndrome differentiation and classification) under the careful guidance of his mentor, Professor Pao Shukang. After this article, a classic medical record is given to express Professor Cypress's experience in the treatment of the disease. In the course of treating this disease, according to the "three causes" of the disease, the four methods of "Tongxiaobingbu" are mainly used to guide the use of medicine, which has a good effect and has clinical guiding significance. The second part of this article is the appendix, the main part of the appendix is literature review, respectively from the Chinese medicine and Western medicine diagnosis and treatment.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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