以三辨论治法治疗腰椎间盘突出症浅谈中西医结合临床思维方法
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摘要
在临床诊疗过程中,既充分利用现代科学各种先进技术和方法,发挥西医对疾病定性定位上的长处,同时又按照中医的理论和方法对疾病进行全面分析,这种中西医结合相互取长补短的思维模式能大大的提高临床诊疗水平。三辨论治法是指在临床诊疗过程中,从辨病、辨证和辨位等各个方面对患者进行科学、综合、全面的分析和判断,指导临床诊断和治疗的一种方法。一辩病,是指接到患者,首先综合思考、分析和判断,做出相应的诊断和辨别诊断,确诊后才能进行下一步的处理。二辨证,即在中医理论的指导下,对患者进行辨证施治~([3])。三辨位,有两个方面:(1)是在中医理论指导下对患者进行分经论治。(2)在解剖学等现代医学的指导下对患者进行神经定位诊断,明确病损病变的部位。作者在临床中常常以三因辨证法的思维方法,运用中药内服外敷、针灸、整脊、功能锻炼等中西医结合疗法综合治疗腰椎间盘突出症等疾病取得较好的疗效,一般患者1~2个疗程既能痊愈。中西医结合下运用中药三辩论治法是笔者临床治疗腰椎间盘突出症患者的经验总结,同时也是在中西医结合临床思维的一些探索。祖国传统医学和现代西方医学各有优势,在临床工作中综合地运用中西、西医的思维取长补短,常常会带来更全面、科学、有效的诊疗方案,值得我们进一步去探索和开发。
In the process of clinical diagnosis and treatment, made full use of modern science and all kinds of advanced technologies and methods, qualitative positioning on the strengths of western medicine on disease, at the same time, according to the theory and method of disease of TCM to conduct a comprehensive analysis of the thinking mode of the combination of Chinese and Western medicine mutual complement each other can greatly improve the level of clinical diagnosis and treatment. Three debate treatment is to point to in the process of clinical diagnosis and treatment, argue from disease, dialectical and contend of patients for various aspects such as scientific, integrated, comprehensive analysis and judgment, to guide clinical diagnosis and treatment of a kind of method. A disease refers to the patient's first comprehensive thinking, analysis and judgment to make the diagnosis and diagnosis, and then the next step will be taken. The second dialectical, that is, under the guidance of TCM theory, dialectical treatment of patients. There are two aspects: 1. To divide and conquer patients under the guidance of TCM theory. 2. Under the guidance of modern medicine, such as anatomy, the patient was diagnosed with nerve localization, and the location of the lesion was clearly identified. The authors often with three because in clinical dialectic thinking method, using Chinese medicine internal and external treatment, acupuncture, chiropractic, functional exercise such as combination therapy integrated traditional Chinese and western medicine therapy such as lumbar intervertebral disc protrusion disease has good curative effect, usually 1-2 period of treatment in patients with both can heal. The combination of traditional Chinese medicine and traditional Chinese medicine is a summary of the author's experience in the treatment of lumbar intervertebral disc herniation, and also some exploration of the combination of Chinese and Western medicine and clinical thinking. Traditional Chinese medicine and modern Western medicine have their own advantages, comprehensive use in clinical work, Western medicine of Chinese and western thinking complement each other, often leads to a more comprehensive, scientific and effective diagnosis and treatment plan, is worth us to explore and develop further.
In the process of clinical diagnosis and treatment, made full use of modern science and all kinds of advanced technologies and methods, qualitative positioning on the strengths of western medicine on disease, at the same time, according to the theory and method of disease of TCM to conduct a comprehensive analysis of the thinking mode of the combination of Chinese and Western medicine mutual complement each other can greatly improve the level of clinical diagnosis and treatment. Three debate treatment is to point to in the process of clinical diagnosis and treatment, argue from disease, dialectical and contend of patients for various aspects such as scientific, integrated, comprehensive analysis and judgment, to guide clinical diagnosis and treatment of a kind of method. A disease refers to the patient's first comprehensive thinking, analysis and judgment to make the diagnosis and diagnosis, and then the next step will be taken. The second dialectical, that is, under the guidance of TCM theory, dialectical treatment of patients. There are two aspects: 1. To divide and conquer patients under the guidance of TCM theory. 2. Under the guidance of modern medicine, such as anatomy, the patient was diagnosed with nerve localization, and the location of the lesion was clearly identified. The authors often with three because in clinical dialectic thinking method, using Chinese medicine internal and external treatment, acupuncture, chiropractic, functional exercise such as combination therapy integrated traditional Chinese and western medicine therapy such as lumbar intervertebral disc protrusion disease has good curative effect, usually 1-2 period of treatment in patients with both can heal. The combination of traditional Chinese medicine and traditional Chinese medicine is a summary of the author's experience in the treatment of lumbar intervertebral disc herniation, and also some exploration of the combination of Chinese and Western medicine and clinical thinking. Traditional Chinese medicine and modern Western medicine have their own advantages, comprehensive use in clinical work, Western medicine of Chinese and western thinking complement each other, often leads to a more comprehensive, scientific and effective diagnosis and treatment plan, is worth us to explore and develop further.
引文
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[7]杨启刚,于涛,高辉.正腰伸筋膏治疗气滞血瘀型腰椎间盘突出症[J].长春中医药大学学报,2014,0(6):1127-1129.
[8]姜静.穴位贴敷结合微波照射对腰椎间盘突出症下腰痛干预的疗效观察及护理体会[J].中医外治杂志,2017,26(2):41-42.
[9]黄小丽.中药药熨配合红外线治疗寒湿型腰椎间盘突出症疗效观察[J].中医临床研究,2017,9(21):97-98.
[10]王鸣鸿,鲍晓,刘惠宇,等.普瑞巴林结合针灸和综合康复训练对腰椎间盘突出症患者的临床疗效研究[J].海军医学杂志,2017,38(3):272-274.
[2]吴在德,吴肇汉.外科学[M].北京:人民卫生出版社,2005:876-878.
[3]田德禄.中医内科学[M].北京:人民卫生出版社,2004:30-333.
[4]龙层花.脊柱病因治疗学[M].香港:商务印书馆,2007:20-12.
[5]刘鲁明.中西医结合临床思维导论[J].浙江中西医结合杂志,2002,12(10):595-596.
[6]邓小斌.手针疗法配合手法治疗腰椎间盘突出症的临床观察[J].中医临床研究,2015,7(28):25-26.
[7]杨启刚,于涛,高辉.正腰伸筋膏治疗气滞血瘀型腰椎间盘突出症[J].长春中医药大学学报,2014,0(6):1127-1129.
[8]姜静.穴位贴敷结合微波照射对腰椎间盘突出症下腰痛干预的疗效观察及护理体会[J].中医外治杂志,2017,26(2):41-42.
[9]黄小丽.中药药熨配合红外线治疗寒湿型腰椎间盘突出症疗效观察[J].中医临床研究,2017,9(21):97-98.
[10]王鸣鸿,鲍晓,刘惠宇,等.普瑞巴林结合针灸和综合康复训练对腰椎间盘突出症患者的临床疗效研究[J].海军医学杂志,2017,38(3):272-274.