1.北京中医药大学 北京 100029
2.首都医科大学附属北京中医医院
陈紫梦,女,在读硕士生
# 孙凤霞,女,博士,教授、主任医师,博士生导师,E-mail:sunfengxia01969@163.com
纸质出版日期:2022-03-30,
收稿日期:2021-08-11,
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陈紫梦, 张莹雪, 孙凤霞, 等. 关幼波教授气血辨证学术思想在肝硬化诊疗中的应用[J]. 现代中医临床, 2022,29(2):23-26,42.
Zimeng CHEN, Yingxue ZHANG, Fengxia SUN, et al. Academic thoughts of Prof.Guan Youbo: Syndrome differentiation of Qi and blood in the diagnosis and treatment of liver cirrhosis[J]. Modern Chinese Clinical Medicine, 2022,29(2):23-26,42.
陈紫梦, 张莹雪, 孙凤霞, 等. 关幼波教授气血辨证学术思想在肝硬化诊疗中的应用[J]. 现代中医临床, 2022,29(2):23-26,42. DOI: 10.3969/j.issn.2095-6606.2022.02.005.
Zimeng CHEN, Yingxue ZHANG, Fengxia SUN, et al. Academic thoughts of Prof.Guan Youbo: Syndrome differentiation of Qi and blood in the diagnosis and treatment of liver cirrhosis[J]. Modern Chinese Clinical Medicine, 2022,29(2):23-26,42. DOI: 10.3969/j.issn.2095-6606.2022.02.005.
肝硬化由各种慢性肝病迁延进展而成,西医治疗以对症防治肝硬化并发症联合保肝治疗为主,中医在对肝硬化的认识和治疗上具有特色。肝硬化根据不同的发展阶段及临床表现,属于中医 “积聚”“臌胀”“急黄”等范畴。关幼波教授重视气血辨证在疾病诊疗中的应用,强调审证必求因、当在气血寻,辨证明病机、气血为主题,治病必治本、气血要遵循。肝硬化发病以气虚血滞为本,湿热疫毒稽留血分为标。气虚血滞是肝硬化发病中的关键病理环节,贯穿在肝硬化发病的各个阶段。痰瘀水湿等既是病理产物,又是使病情进展的主要因素。关教授认为治疗应以补气活血为主,兼化痰利湿,或养阴清热,或行气利水,或扶正固脱、开窍醒神等。分别从早期肝硬化、肝硬化腹水、急性肝昏迷介绍关教授气血辨证学术思想在肝硬化诊疗中的应用,并结合临床病案进行说明,为临床辨治提供参考。
Liver cirrhosis is often derived from chronic liver diseases. In Western medicine
the treatment is centered on the treatment and prevention of cirrhosis-related complications and on liver protection. Traditional Chinese medicine has unique features as to its cognition and treatment. Liver cirrhosis
corresponds to "abdominal masses"
"swelling" and "acute jaundice" in Traditional Chinese medicine based on its staging and clinical manifestations. Professor Guan Youbo attached importance to syndrome differentiation of Qi and blood theory in its diagnosis and treatment
as diagnosis necessitates determination of etiologic factors from the perspective of qi and blood and in pattern identification. In his opinion
pathogenesis should be figured out centered on qi and blood and in treatment
and its root cause should be focused on. The root cause of liver cirrhosis is Qi deficiency and blood stagnation with dampness-heat toxins retained in the blood aspect as its symptoms. As a key part of pathogenesis of liver cirrhosis
Qi deficiency and blood stasis
which runs through the whole process of liver cirrhosis
has important effects on the formation and development of main syndrome. Phlegm and blood stasis and dampness are not only pathological products
but also the aggravation factors. In Professor Guan’s opinion
invigorating Qi and promoting blood circulation are fundamental treatments. In addition
dispelling phlegm and dampness
nourishing yin and clearing heat
promoting Qi and fluids
invigorating Qi and reviving spirits
and so on are selected according to patients’ condition. This paper introduces the application of Professor Guan’s academic thoughts of Qi and blood theory in the diagnosis and treatment of liver cirrhosis
and provides references for clinical differentiation and treatment with referrence to clinical medical records.
气血辨证肝硬化名医经验关幼波
syndrome differentiation of Qi and bloodliver cirrhosisfamous physicians’ experienceGuan Youbo
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