基于肾脑相济理论探析裘昌林教授辨治多系统萎缩的临证经验

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英文篇名：Professor QIU Changlin's Clinical Experience of Multiple System Atrophy Based on the Theory of Kidney-Brain Interaction 作者：陆佳宁 ; 张丽萍 ; 冯秀珍 ; 陈靖茹 英文作者：LU Jianing;ZHANG Liping;FENG Xiuzhen;Zhejiang Chinese Medical University;The First Affiliated Hospital of Zhejiang Chinese Medical University; 关键词：多系统萎缩 ; 肾脑相济 ; 肾元亏虚 ; 地黄引子 ; 络病 ; 医案 ; 裘昌林 ; 名医经验 英文关键词：multiple system atrophy;;kidney-brain interaction;;kidney deficiency;;Dihuang Yinzi decoction;;collateral disease;;medical records;;QIU Changlin;;clinical experience 中文刊名：BHON 英文刊名：Journal of Zhejiang Chinese Medical University 机构：浙江中医药大学;浙江中医药大学附属第一医院; 出版日期：2019-01-15 出版单位：浙江中医药大学学报 年：2019 期：v.43;No.291 基金：浙江省中医药科技计划项目(2015ZA091,2016ZA068)~~ 语种：中文; 页：BHON201901004 页数：5 CN：01 ISSN：33-1349/R 分类号：18-22

摘要

[目的]探析裘昌林教授辨治多系统萎缩的临证经验。[方法]通过跟师学习、整理医案等方式,以肾脑相济理伦为切入点,从理论基础、辨证论治及临证心法3个方面展开,分析总结裘昌林教授运用中医中药辨治多系统萎缩的临床经验,并例举医案予以验证。[结果]裘教授指出,肾脑之间在结构、生理及病理上相互联系,相互影响,脑髓之源滥觞于肾精;多系统萎缩(multiple system atrophy,MSA)病位在脑,多由虚损所致,兼或实邪为患,乃本虚标实之症,分列肾元亏虚、湿热浸淫、阴虚内热、肾阳虚衰为本病的主要分型;临证以补肾生髓为治本之法,兼以化瘀通络、升压定眩,对于治疗本病及改善临床症状疗效显著。所举医案,具体展示了上述辨证思路和治疗经验。[结论]裘教授从肾脑相济理论入手,正确认识多系统萎缩并以中医中药分证辨治该病疗效确定,副反应少,值得大力传承并予推广。
        [Objective] To summarize Professor QIU Changlin's clinical experience on multiple system atrophy. [Methods] In the way of learning from the teacher and typical medical cases to analyze and summarize the Professor QIU Changlin 's clinical experience on multiple system atrophy from the coordinating kidney and brain via the etiology and pathogenesis, the clinical experience and the syndrome differentiation these three respects. Then enumerate medical records to validate it. [Results] Professor QIU points out: The structure, physiology and pathology of kidney and brain interrelate and influence each other. The origin of brain medulla originates from kidney essence; MSA locates in brain, which is caused by deficiency. It is a disease of deficiency and excess, which is divided into deficiency of liver and kidney, dampness and heat, heat in Yin deficiency and deficiency of kidney-Yang.Taking tonifying the kidney and promoting marrow as a permanent cure, removing blood stasis and clear collaterals, rising blood pressure and setting dizziness for the treatment of this disease. It is an effective option for relieving the clinical symptoms of the disease. And the method is helpful for clinical application. [Conclusion] Professor QIU Changlin correctly understanding multiple system atrophy and treating the disease with Chinese medicine with determined curative effect from the perspective of the kidney, less side effect, is worth inheriting and promoting vigorously.

引文

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