欧阳恒学术经验总结及治疗慢性荨麻疹的临床研究
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摘要
目的：
①整理欧阳恒教授学术思想、学术成果、临床经验等资料；②深入挖掘欧阳恒学术思想及临床方药的价值；③系统总结欧阳恒学术思想,形成集理法方药于一体的临床论治思想,出版专著；④继承欧阳恒学术精髓,延伸学术理论,创新论治方药及方法,推广学术成果；⑤总结汇集皮科近现代相关各流派、各医家的学术观点,与欧阳恒教授学术思想进行对比研究；⑥整理欧阳恒教授治疗慢性荨麻疹理法方药,探讨其验方—当归玉真汤治疗阳虚寒凝痰阻型慢性荨麻疹的临床疗效。
方法：
①收集整理欧阳恒教授各类资料：欧阳恒从医以来在临床中亲自记录的各类验案验方验证等文字资料、历年来各自跟师学徒的临床笔记、欧阳恒教授临证的各类效验病案、欧阳恒所带学生记录的临床笔记、公开出版的专著、发表的相关论文等。②通过复诊病人或医护随访从侧面了解欧阳恒治疗皮肤病案例,并记录或照相其临床病例、方药、复诊情况等。③分门别类,整理成册,全面总结欧阳恒教授在皮肤性病诊疗中形成的学术思想,包括创新理论、辨病方法、辨证思路、治则治法、选方用药、外治特色、药剂配制、预防调摄等。④精炼出欧阳恒教授论治各类病种的中医诊疗方案,并整理成文,编辑成书,继而推广运用临床。⑤在欧阳恒学术经验总结的基础上,抽取临床效验方药,进行深入临床及实验室研究,即“温阳化痰”之当归玉真散经制剂加工成片剂治疗阳虚寒凝痰阻型慢性荨麻疹,通过临床疗效观察、复发随访,结合检测对比治疗前后及与对照组实验室指标的改善情况,即炎性介质T-工gE、嗜酸细胞阳离子蛋白和外周血嗜碱性粒细胞的计数等,为当归玉真片在临床上的推广应用提供临床和实验室依据,为该类疾病的辨证与论治提供新的思路。
结果：
欧阳恒教授在长期皮肤病临证过程中,逐渐形成了集理、法、方、药于一体的皮肤病中医论治体系。一、辨病辨证特色：①中西医结合应以明病为先；②病证取舍以实用为原则；③病证并论,注重发挥中医特色；④辨病与辨证结合,以提高疗效为出发点。二、诊疗创新特色：对湿疹、银屑病、带状疱疹及慢性荨麻疹的提出了新的诊疗规范,具有重要的临床价值。三、临证方药特色：遵循辨证施治、大法大方的基础,运用取类比象法,体现中医特色和优势,独创直观论治思想,即①以色治色法,即以用药之色反其病色的治疗方法；②以形治形法,即以用药之外形相形病象的治疗方法；③以皮治皮法,即以药之皮部入药治疗皮病的方法；④寓搔意治瘙法,即是模拟搔抓之类外部形象相对选用带勾、刺、棘类药物的治疗方法。其他参以“以毒攻毒”法,“红升、白降外科家当”说等；总结出欧阳恒自创方剂30余首,临床疗效确切,深受医患好评；善用“象”类中药,如色象类中药、有形类中药、核仁类中药、皮类中药、有毒类中药、虫类药等。其次善用“参”类药、对药及引经药；皮病外治：重视外治,提倡外以通内,剂型创制,主张使用中药类软膏,避免激素类药物带来的副作用。创制及改良外用药物,如僧黄膏、紫铜消白酊、小儿湿疹外洗方、皮炎外洗方、肿疡外洗方、汗疱疹方、复方二矾散、白斑外搽剂、扁平疣洗方等。四、各家经验总结：总结了近现代以来皮肤科著名医家学术思想及临床经验,如赵炳南、朱仁康、张志礼、榻国维、徐宜厚、王玉玺、张毅等。五、总结了欧阳恒论治慢性荨麻疹的经验：从慢性荨麻疹的病因病机出发,认为阳虚寒凝和风痰阻络是本病发病的根本。通过大量临床病例观察,收集整理,综合四诊,自拟阳虚寒凝痰阻证,治以温阳散寒、养血通脉、熄风化痰之法,运用经验方当归玉真散,治疗本病疗效确切。六、当归玉真片临床研究提示：“温阳化痰”之当归玉真片治疗慢性荨麻疹,临床疗效确切,能明显缩短风团消退时间、减少风团数目、减缓皮肤瘙痒、改善生活质量,在改善症状体征、降低血清IgE及ECP等方面明显优于西替利嗪对照组。两组治疗4周后总有效率比较,治疗组与对照比较,x2=9.93>x20.05.1=3.84,(P<0.05),差异有显著性。治疗4疗程后对各痊愈病例进行追踪随访,随访2个月,复发情况比较：治疗组复发率明显低于对照组,两组复发率比较差异有统计学意义(P<0.05)。
结论：
①欧阳恒教授从事中医外科临床、教学、科研工作50余年,积累了丰富的临床经验,并逐步形成了自己的学术观点和临证诊疗特色,取得了较大的学术成就。②欧阳恒学术经验的总结继承有较高而深远的学术及临床价值。③以欧阳恒教授学术思想传承为中心,立足于临床实际,可发挥名医效应与优势,因地因人制宜,挖掘名医潜力、突显中医特色、培养后背人才、实现中医皮肤科的可持续发展。④可推广欧阳恒学术经验,从学术思想、理论创新、辨病辨证、治法方药、特色外治、专病专药、自制药等诸多方面推广学术成果,惠及业内中医皮科工作者及广大皮病患者。⑤当归玉真片对慢性荨麻疹(阳虚寒凝痰阻证)能显著改善症状体征,临床疗效确切,远期疗效较佳,无毒副作用,值得在临床进一步推广应用。
Objective:
①To tidy up the academic thought, academic achievement and clinical experience of Professor Ouyang Heng;②To dig deep into the value of academic thought and clinical prescriptions of Professor Ouyang;③To summarize of the academic thought, the formation of published monographs and clinical thought of treatment fused with theory, method, formula and drug systematically④To inherite the academic essence, extend academic theory, innovate the prescriptions and methods,then promote academic achievement;⑤To summarize Modern related various schools,the academic point of view, then compare with that of Professor Ouyang Heng;⑥To tidy up the theory, method, formula and drug of Professor Ouyang Heng on urticaria, study the Clinical effect of Yuzhen San on the treatment of chronic urticaria with syndrome of yang deficiency and coagulated cold.
Methods:
⑦Collecte any types of information about Professor Ouyang Heng, such as text data including clinical experience, medical records, published monograph,and so on.②Learn skin medical record,record cases of treatment of skin diseases by further consultation and follow-up visit.③category, organize into volumes, comprehensive summarize diagnosis and treatment of sexually transmitted diseases in the skin form of academic ideas of Professor Ouyang Heng including innovative theories, methods of identifying diseases, dialectical thinking, treatment, cure, and election administration side, external governance characteristics, pharmaceutical preparation, prevention photo transfer, etc.④refine the theory of traditional Chinese medicine treatment of various diseases, treatment programs, and organize written and compiled book, and then promote to clinic use.⑤based on the academic thought, taking clinical effective prescription drugs for in-depth clinical and laboratory studies, the "yang phlegm" and Angelica Yuzhen San Hanning treatment of chronic urticaria, through clinical observation recurrence follow-up, testing before and aftter treatment compared with the control group, the improvement in laboratory tests, that inflammatory mediators, T-IgE, eosinophil cationic protein and peripheral blood basophils count, etc., which is good for the clinical application of Angelica Yuzhen San by providing clinical and laboratory basis for the differentiation of such diseases and providing new ideas on governanc.⑥a lot of clinical studies of Yuzhen San showed that the Curative effect of Yuzhen San is favorable,which can shorten the time of urticaria,reduce the number of urticaria, relieve Skin Itching, improvehe quality of live, it is shown that it is better than the control group in improving syndrome,reducing serum IgE and ECP. Significant differences of the total effective rate were found between treatment and control groups x2=9.93> x20.05,1=3.84,(P<0.05),The rcurrence rate of treatment group is lower than control group after4treatment courses(P<0.05)
Results:
During long-term process of Clinical Dermatology,Professor Ouyang Heng gradually formed a system of theory, method, formula and drug on the governance system of Traditional Chinese Medicine,(1) theoretical summary:①Integrative Medicine should be out sick for the first;②Syndrome choose to practical principle;③syndrome and desease, pay attention to Chinese characteristics;④combination of diseases and syndromes, to improve efficacy as a starting point.(2) characteristics creative therapy:①cure color with color treatment method;②cure pustular psoriasis by stages;③cure neurodynia of herpes zoster by trigeminy;④cure herpes zoster based on different part of body.⑤cure psoriasis by quintuplet of TCM.(3)the characteristic of clinical medicine. create their own recipe:①"color to the color rule," treatment of pigmented skin;②use of "like" Chinese herbs, Chinese herbs, such as color as the visible Chinese herbs, nuts Chinese herbs,③skin disease outside the treatment:attention to foreign rule, to promote foreign to pass, the formulations created, advocated the use of Chinese herbal ointment, avoid steroids side effects Chinese herbs skin, toxic Chinese herbs, medicines and other insects.④Summary of European old white square own copper consumption, eliminate the white mixture, cream mixture, Angelica Yuzhen scattered, Zhuhuang soup, three vitiligo, black and other prescription diet more than30first side, clinical efficacy, by patient received. clinical medicine:Second, use of "reference" drugs, the drugs and cited by the drug. clinical experience:Treatment of pustular psoriasis in phases; triple combination treatment of postherpetic neuralgia; split on the rule herpes zoster; Chinese five of the treatment of advanced psoriasis. Created and improved topical drugs, such as the monk yellow paste, copper consumption Tincture, pediatric eczema Washing side, dermatitis Washing side, swollen ulcer Washing side, sweat herpes side, compound two alum powder, white external liniment, warts wash Fang.(4) various lessons learned:summarize the clinical experience and academic thought,of modern dermatology such as Zhao Bingnan, Zhu Renkang, Zhang Zhi-li, Xuan Nations peacekeeping, Xu, Wang Yuxi, Zhang Yi and so on (5) By a large number of clinical cases observed, collected, integrated four diagnostic, self Yang Hanning Phlegm permit rule to yang and cold, nourishing Tongmai, Xifeng phlegm of the law, to use his experience side Angelica Yuzhen San, treatment on the disease is effective.(6)the clinical and experimental research of Angelica Yuzhen San:"yang phlegm" in the treatment of chronic urticaria Angelica San Yuzhen, the clinical efficacy is clear,which can significantly shorten the time the wind subsided group, reducing the number of air missions, reduce skin itching and improve the quality of life, it is better than cetirizine group in improving symptoms and signs, lower serum IgE and ECP.
Conclusion:
①Professor Ouyang Heng has been engaged in clinical medicine, teaching, researching for50years, accumulated abundant clinical experience, formed his own academic thought and treatment characteristics, and made great academic achievements gradually.②The summary of academical experience has far-reaching academic and clinical value.③The Professor Ouyang Heng heritage as the center of academic thinking, based on clinical practice, could develop the advantages of famous doctor tap the potential of doctors, highlights Chinese characteristics, personnel training back,then achieve sustainable development of traditional Chinese medicine dermatology.④Ouyang Heng's academic experience can be extended, from the academic thought, theoretical innovation, and distinguish the disease syndromes, therapies and formulas, features outside the rule, designed specifically disease drug, pharmaceutical and many other aspects of self-promoting academic achievement, from witch doctors and patients would be benefit.⑤Angelica Yuzhen San can significantly improve the symptoms and signs of chronic urticaria (Yang and Hanning-type), and the clinical efficacy is exact and long-term,furthermore has non-toxic side effects,so it is worth further clinical application.
①整理欧阳恒教授学术思想、学术成果、临床经验等资料；②深入挖掘欧阳恒学术思想及临床方药的价值；③系统总结欧阳恒学术思想,形成集理法方药于一体的临床论治思想,出版专著；④继承欧阳恒学术精髓,延伸学术理论,创新论治方药及方法,推广学术成果；⑤总结汇集皮科近现代相关各流派、各医家的学术观点,与欧阳恒教授学术思想进行对比研究；⑥整理欧阳恒教授治疗慢性荨麻疹理法方药,探讨其验方—当归玉真汤治疗阳虚寒凝痰阻型慢性荨麻疹的临床疗效。
方法：
①收集整理欧阳恒教授各类资料：欧阳恒从医以来在临床中亲自记录的各类验案验方验证等文字资料、历年来各自跟师学徒的临床笔记、欧阳恒教授临证的各类效验病案、欧阳恒所带学生记录的临床笔记、公开出版的专著、发表的相关论文等。②通过复诊病人或医护随访从侧面了解欧阳恒治疗皮肤病案例,并记录或照相其临床病例、方药、复诊情况等。③分门别类,整理成册,全面总结欧阳恒教授在皮肤性病诊疗中形成的学术思想,包括创新理论、辨病方法、辨证思路、治则治法、选方用药、外治特色、药剂配制、预防调摄等。④精炼出欧阳恒教授论治各类病种的中医诊疗方案,并整理成文,编辑成书,继而推广运用临床。⑤在欧阳恒学术经验总结的基础上,抽取临床效验方药,进行深入临床及实验室研究,即“温阳化痰”之当归玉真散经制剂加工成片剂治疗阳虚寒凝痰阻型慢性荨麻疹,通过临床疗效观察、复发随访,结合检测对比治疗前后及与对照组实验室指标的改善情况,即炎性介质T-工gE、嗜酸细胞阳离子蛋白和外周血嗜碱性粒细胞的计数等,为当归玉真片在临床上的推广应用提供临床和实验室依据,为该类疾病的辨证与论治提供新的思路。
结果：
欧阳恒教授在长期皮肤病临证过程中,逐渐形成了集理、法、方、药于一体的皮肤病中医论治体系。一、辨病辨证特色：①中西医结合应以明病为先；②病证取舍以实用为原则；③病证并论,注重发挥中医特色；④辨病与辨证结合,以提高疗效为出发点。二、诊疗创新特色：对湿疹、银屑病、带状疱疹及慢性荨麻疹的提出了新的诊疗规范,具有重要的临床价值。三、临证方药特色：遵循辨证施治、大法大方的基础,运用取类比象法,体现中医特色和优势,独创直观论治思想,即①以色治色法,即以用药之色反其病色的治疗方法；②以形治形法,即以用药之外形相形病象的治疗方法；③以皮治皮法,即以药之皮部入药治疗皮病的方法；④寓搔意治瘙法,即是模拟搔抓之类外部形象相对选用带勾、刺、棘类药物的治疗方法。其他参以“以毒攻毒”法,“红升、白降外科家当”说等；总结出欧阳恒自创方剂30余首,临床疗效确切,深受医患好评；善用“象”类中药,如色象类中药、有形类中药、核仁类中药、皮类中药、有毒类中药、虫类药等。其次善用“参”类药、对药及引经药；皮病外治：重视外治,提倡外以通内,剂型创制,主张使用中药类软膏,避免激素类药物带来的副作用。创制及改良外用药物,如僧黄膏、紫铜消白酊、小儿湿疹外洗方、皮炎外洗方、肿疡外洗方、汗疱疹方、复方二矾散、白斑外搽剂、扁平疣洗方等。四、各家经验总结：总结了近现代以来皮肤科著名医家学术思想及临床经验,如赵炳南、朱仁康、张志礼、榻国维、徐宜厚、王玉玺、张毅等。五、总结了欧阳恒论治慢性荨麻疹的经验：从慢性荨麻疹的病因病机出发,认为阳虚寒凝和风痰阻络是本病发病的根本。通过大量临床病例观察,收集整理,综合四诊,自拟阳虚寒凝痰阻证,治以温阳散寒、养血通脉、熄风化痰之法,运用经验方当归玉真散,治疗本病疗效确切。六、当归玉真片临床研究提示：“温阳化痰”之当归玉真片治疗慢性荨麻疹,临床疗效确切,能明显缩短风团消退时间、减少风团数目、减缓皮肤瘙痒、改善生活质量,在改善症状体征、降低血清IgE及ECP等方面明显优于西替利嗪对照组。两组治疗4周后总有效率比较,治疗组与对照比较,x2=9.93>x20.05.1=3.84,(P<0.05),差异有显著性。治疗4疗程后对各痊愈病例进行追踪随访,随访2个月,复发情况比较：治疗组复发率明显低于对照组,两组复发率比较差异有统计学意义(P<0.05)。
结论：
①欧阳恒教授从事中医外科临床、教学、科研工作50余年,积累了丰富的临床经验,并逐步形成了自己的学术观点和临证诊疗特色,取得了较大的学术成就。②欧阳恒学术经验的总结继承有较高而深远的学术及临床价值。③以欧阳恒教授学术思想传承为中心,立足于临床实际,可发挥名医效应与优势,因地因人制宜,挖掘名医潜力、突显中医特色、培养后背人才、实现中医皮肤科的可持续发展。④可推广欧阳恒学术经验,从学术思想、理论创新、辨病辨证、治法方药、特色外治、专病专药、自制药等诸多方面推广学术成果,惠及业内中医皮科工作者及广大皮病患者。⑤当归玉真片对慢性荨麻疹(阳虚寒凝痰阻证)能显著改善症状体征,临床疗效确切,远期疗效较佳,无毒副作用,值得在临床进一步推广应用。
Objective:
①To tidy up the academic thought, academic achievement and clinical experience of Professor Ouyang Heng;②To dig deep into the value of academic thought and clinical prescriptions of Professor Ouyang;③To summarize of the academic thought, the formation of published monographs and clinical thought of treatment fused with theory, method, formula and drug systematically④To inherite the academic essence, extend academic theory, innovate the prescriptions and methods,then promote academic achievement;⑤To summarize Modern related various schools,the academic point of view, then compare with that of Professor Ouyang Heng;⑥To tidy up the theory, method, formula and drug of Professor Ouyang Heng on urticaria, study the Clinical effect of Yuzhen San on the treatment of chronic urticaria with syndrome of yang deficiency and coagulated cold.
Methods:
⑦Collecte any types of information about Professor Ouyang Heng, such as text data including clinical experience, medical records, published monograph,and so on.②Learn skin medical record,record cases of treatment of skin diseases by further consultation and follow-up visit.③category, organize into volumes, comprehensive summarize diagnosis and treatment of sexually transmitted diseases in the skin form of academic ideas of Professor Ouyang Heng including innovative theories, methods of identifying diseases, dialectical thinking, treatment, cure, and election administration side, external governance characteristics, pharmaceutical preparation, prevention photo transfer, etc.④refine the theory of traditional Chinese medicine treatment of various diseases, treatment programs, and organize written and compiled book, and then promote to clinic use.⑤based on the academic thought, taking clinical effective prescription drugs for in-depth clinical and laboratory studies, the "yang phlegm" and Angelica Yuzhen San Hanning treatment of chronic urticaria, through clinical observation recurrence follow-up, testing before and aftter treatment compared with the control group, the improvement in laboratory tests, that inflammatory mediators, T-IgE, eosinophil cationic protein and peripheral blood basophils count, etc., which is good for the clinical application of Angelica Yuzhen San by providing clinical and laboratory basis for the differentiation of such diseases and providing new ideas on governanc.⑥a lot of clinical studies of Yuzhen San showed that the Curative effect of Yuzhen San is favorable,which can shorten the time of urticaria,reduce the number of urticaria, relieve Skin Itching, improvehe quality of live, it is shown that it is better than the control group in improving syndrome,reducing serum IgE and ECP. Significant differences of the total effective rate were found between treatment and control groups x2=9.93> x20.05,1=3.84,(P<0.05),The rcurrence rate of treatment group is lower than control group after4treatment courses(P<0.05)
Results:
During long-term process of Clinical Dermatology,Professor Ouyang Heng gradually formed a system of theory, method, formula and drug on the governance system of Traditional Chinese Medicine,(1) theoretical summary:①Integrative Medicine should be out sick for the first;②Syndrome choose to practical principle;③syndrome and desease, pay attention to Chinese characteristics;④combination of diseases and syndromes, to improve efficacy as a starting point.(2) characteristics creative therapy:①cure color with color treatment method;②cure pustular psoriasis by stages;③cure neurodynia of herpes zoster by trigeminy;④cure herpes zoster based on different part of body.⑤cure psoriasis by quintuplet of TCM.(3)the characteristic of clinical medicine. create their own recipe:①"color to the color rule," treatment of pigmented skin;②use of "like" Chinese herbs, Chinese herbs, such as color as the visible Chinese herbs, nuts Chinese herbs,③skin disease outside the treatment:attention to foreign rule, to promote foreign to pass, the formulations created, advocated the use of Chinese herbal ointment, avoid steroids side effects Chinese herbs skin, toxic Chinese herbs, medicines and other insects.④Summary of European old white square own copper consumption, eliminate the white mixture, cream mixture, Angelica Yuzhen scattered, Zhuhuang soup, three vitiligo, black and other prescription diet more than30first side, clinical efficacy, by patient received. clinical medicine:Second, use of "reference" drugs, the drugs and cited by the drug. clinical experience:Treatment of pustular psoriasis in phases; triple combination treatment of postherpetic neuralgia; split on the rule herpes zoster; Chinese five of the treatment of advanced psoriasis. Created and improved topical drugs, such as the monk yellow paste, copper consumption Tincture, pediatric eczema Washing side, dermatitis Washing side, swollen ulcer Washing side, sweat herpes side, compound two alum powder, white external liniment, warts wash Fang.(4) various lessons learned:summarize the clinical experience and academic thought,of modern dermatology such as Zhao Bingnan, Zhu Renkang, Zhang Zhi-li, Xuan Nations peacekeeping, Xu, Wang Yuxi, Zhang Yi and so on (5) By a large number of clinical cases observed, collected, integrated four diagnostic, self Yang Hanning Phlegm permit rule to yang and cold, nourishing Tongmai, Xifeng phlegm of the law, to use his experience side Angelica Yuzhen San, treatment on the disease is effective.(6)the clinical and experimental research of Angelica Yuzhen San:"yang phlegm" in the treatment of chronic urticaria Angelica San Yuzhen, the clinical efficacy is clear,which can significantly shorten the time the wind subsided group, reducing the number of air missions, reduce skin itching and improve the quality of life, it is better than cetirizine group in improving symptoms and signs, lower serum IgE and ECP.
Conclusion:
①Professor Ouyang Heng has been engaged in clinical medicine, teaching, researching for50years, accumulated abundant clinical experience, formed his own academic thought and treatment characteristics, and made great academic achievements gradually.②The summary of academical experience has far-reaching academic and clinical value.③The Professor Ouyang Heng heritage as the center of academic thinking, based on clinical practice, could develop the advantages of famous doctor tap the potential of doctors, highlights Chinese characteristics, personnel training back,then achieve sustainable development of traditional Chinese medicine dermatology.④Ouyang Heng's academic experience can be extended, from the academic thought, theoretical innovation, and distinguish the disease syndromes, therapies and formulas, features outside the rule, designed specifically disease drug, pharmaceutical and many other aspects of self-promoting academic achievement, from witch doctors and patients would be benefit.⑤Angelica Yuzhen San can significantly improve the symptoms and signs of chronic urticaria (Yang and Hanning-type), and the clinical efficacy is exact and long-term,furthermore has non-toxic side effects,so it is worth further clinical application.
引文
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