金实教授肝病诊治经验探析

发布时间：2018-11-13 18:15

【摘要】：目的:金实教授师从肝病泰斗邹良才,并获邹云翔、曹鸣高、付宗翰、张泽生、周仲英等名医教诲,经验体会,临床研究实践,对肝病有着深入治疗心得。并且擅用古方,不拘泥,卓立创新。以自身对肝病的临床经验及中医内科辨证施治,熟悉肝病的发病机制及治疗原则,秉持着对中医中药的热忱,以中药药理对肝病治疗取得疗效。病毒性肝炎治疗,自拟龙柴方,寓于清热解毒,疏肝健脾,配以平地木、叶下珠、板蓝根、土茯苓等抗病毒来抑制病毒的蔓延发展均有良好的成效。自身免疫性肝炎肝炎的治疗,采用“流气和络”治之,用药轻灵,求变求新,不拘泥古法。肝硬化疾病的治疗,辨病虚实,急则治标,缓则治本,虚实夹杂,则标本兼治。故此课题乃是针对金实教授治疗肝病的用药辨证思路及法则,使得肝病的治疗可以有更多的选择,金师的学术可以继续传承。方法:病例收集来源于江苏省中医院门诊、南京中医药大学百草堂门诊部、南京中医药大学国医堂门诊部,2009年3月至2013年12月门诊病例。并从病名、病因病机、治疗原则、辨证论治、用药特点等方面探析金实教授治疗肝胆病临床经验。结果:病毒性肝炎总得病机是毒邪稽留,正气不足;自身免疫性肝炎病机是肝络郁滞,本虚标实;肝硬化病机是肝脾失调,气血阴阳不和。结论:肝胆病是现代临床最常见的疾病,病多夹杂蔓延时日甚久,严重甚至牵动机体的免疫调节,进而危及生命。目前临床用于治疗肝胆病的方式,针对不同情况的疾病发生,给予不同的的西药,大多只有单一性,没有办法有效全面的治疗疾病或恢复肝功能。再者,某些西药又因存在对肾功能或其他脏器损害,胚胎畸形,白细胞下降等副作用,限制了其在临床的应用。金实教授透过中医的辨证,结合西医的诊断,中药的药理研究,可从整体调控入手,通过药理作用的效果恢复肝功能正常,临床经验值得推广。
[Abstract]:Objective: professor Jin Shi was taught and experienced by famous doctors such as Zou Yunxiang, Cao Minggao, Fu Zonghan, Zhang Zesheng, Zhou Zhongying, and clinical research practice. And good at using the ancient square, not rigid, Zhuo Li innovation. With its own clinical experience of liver disease and TCM internal medicine dialectical treatment, familiar with the pathogenesis and treatment principles of liver disease, adhering to the enthusiasm of traditional Chinese medicine, Chinese medicine pharmacology to obtain curative effect on liver disease. Viral hepatitis treatment, self-made Longchaifang, living in clearing heat and detoxification, liver and spleen, with Pingdi wood, leaf beads, Radix Isatidis, Poria cocos and other antivirus to suppress the spread of the virus has good results. The treatment of autoimmune hepatitis is treated by "flowing qi and collaterals". The treatment of liver cirrhosis disease, differentiation of deficiency and solid, urgent treatment of symptoms, slow treatment of the root cause, the mix of deficiency and reality, then both symptoms and symptoms. Therefore, the subject is aimed at Professor Jin Shi's thinking and rules of medicine differentiation in the treatment of liver disease, so that the treatment of liver disease can have more choices, and the academic work of Jin Shi can continue to be passed on. Methods: the cases were collected from the outpatient department of Jiangsu Provincial traditional Chinese Medicine Hospital, the outpatient Department of Baicaotang Hospital of Nanjing University of traditional Chinese Medicine and the outpatient Department of National Medical Hall of Nanjing University of traditional Chinese Medicine, from March 2009 to December 2013. And from the name, etiology, pathogenesis, treatment principles, syndrome differentiation, drug characteristics and other aspects of Jinshi professor treatment of liver and gallbladder disease clinical experience. Results: the general pathogenesis of viral hepatitis was the stagnation of toxin and qi, the pathogenesis of autoimmune hepatitis was stagnation of liver and collaterals, and the pathogenesis of liver cirrhosis was liver and spleen disorder, qi and blood yin and yang disharmony. Conclusion: hepatobiliary disease is the most common disease in modern clinic. At present, the clinical treatment of hepatobiliary diseases, according to the occurrence of different cases of diseases, given different western medicine, most of the only single, there is no effective and comprehensive treatment of diseases or restore liver function. Moreover, some western medicine has side effects on renal function or other organs, embryo malformation, leukopenia, etc., which limits its clinical application. Professor Jin Shi, through the differentiation of TCM syndrome, the diagnosis of western medicine and the pharmacological research of Chinese medicine, can start with the whole regulation and control, and restore the normal liver function through the effect of pharmacological action. The clinical experience is worth popularizing.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R249;R259

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