国医大师洪广祥“中医救急”经验浅析
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摘要
呼吸衰竭是临床危急重证,国医大师洪广祥教授将其分为热毒犯肺、痰火壅肺、腑结肺痹、气阴两竭、痰瘀阻肺、水凌心肺、喘脱等7类证型,分别对应清热解毒、泻火逐痰、通下救肺、益气救阴、祛痰行瘀、温阳利水、回阳固脱等7类治法,并结合其兼证、转归延伸出一系列应对方法。以呼吸衰竭治疗经验为例,由此引发了"中医救急"的系统性思考,即"提纲挈领辨病证"是先决条件,"争分夺秒论施治"是有力武器,"运筹帷幄判转归"是后续保障。
Respiratory failure is a critical and serious disease in clinic. The TCM master professor HONG Guangxiang divides it into 7 syndrome-types, such as syndrome of heat-toxic invading lung, syndrome of phlegm-heat obstructing lung,syndrome of colon blocking and lung obstructing. These syndrome-types correspond to 7 therapeutic methods respectively, such as clearing heat and removing toxicity, clearing fire and driving out phlegm and fire and relaxing colon and rescuing lung. In addition,the master proposes a series of coping methods combined with its concurrent syndrome and prognosis. Taking the experiences in treatment of respiratory failure as example it leads us a systematic thinking of ‘TCM for emergency', namely, ‘concentrate on the main points and syndrome differentiation' is a prerequisite, ‘seize every minute and second to cogitate and implement treatment' is a powerful weapon, ‘have the situation well in hand and judge prognosis' is a follow-up insurance.
Respiratory failure is a critical and serious disease in clinic. The TCM master professor HONG Guangxiang divides it into 7 syndrome-types, such as syndrome of heat-toxic invading lung, syndrome of phlegm-heat obstructing lung,syndrome of colon blocking and lung obstructing. These syndrome-types correspond to 7 therapeutic methods respectively, such as clearing heat and removing toxicity, clearing fire and driving out phlegm and fire and relaxing colon and rescuing lung. In addition,the master proposes a series of coping methods combined with its concurrent syndrome and prognosis. Taking the experiences in treatment of respiratory failure as example it leads us a systematic thinking of ‘TCM for emergency', namely, ‘concentrate on the main points and syndrome differentiation' is a prerequisite, ‘seize every minute and second to cogitate and implement treatment' is a powerful weapon, ‘have the situation well in hand and judge prognosis' is a follow-up insurance.
引文
[1]余建玮,薛汉荣,张元兵,等.国医大师洪广祥教授诊疗肺系疾病学术思想荟萃.中华中医药杂志,2015,30(11):3824-3829
[2]柯诗文,朱伟,刘良徛.国医大师洪广祥教授温清并用治疗慢性阻塞性肺疾病浅析.中华中医药杂志,2018,33(5):1965-1967
[3]洪广祥.中医药论治呼吸衰竭.中医药通报,2007,6(4):6-11
[4]苑超.中医在重症呼吸衰竭治疗中的应用及价值评价.中国医药指南,2017,15(10):196-197
[5]赵明明,陈国华,杭燕萍,等.中西医结合治疗慢性呼吸衰竭临床研究.亚太传统医药,2017,13(4):96-97
[6]付跃峰,刘清泉,蔡阳平,等.AECOPD呼吸衰竭中医证素、症候的分布及与胃肠功能障碍相关研究.世界中医药,2014,9(3):265-274
[7]任建,敖素华.承气灌肠液联合无创通气治疗AECOPD呼吸衰竭的临床研究.世界最新医学信息文摘,2017,17(A2):4-6
[8]焦莉.慢性阻塞性肺病急性加重期呼吸衰竭中医辨治规范化研究.广州:广州中医药大学,2011:22-23
[9]钟章炼,梁锐记.参附注射液联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的临床分析.中国现代药物应用,2017,11(21):111-113
[10]曾汇霞.急性呼吸衰竭的预后转归及证候趋势的观察.广州:广州中医药大学,2014:29-30
[11]刘良徛.洪广祥治喘脱证验案3则.江西中医药,2000,31(6):1-2
[2]柯诗文,朱伟,刘良徛.国医大师洪广祥教授温清并用治疗慢性阻塞性肺疾病浅析.中华中医药杂志,2018,33(5):1965-1967
[3]洪广祥.中医药论治呼吸衰竭.中医药通报,2007,6(4):6-11
[4]苑超.中医在重症呼吸衰竭治疗中的应用及价值评价.中国医药指南,2017,15(10):196-197
[5]赵明明,陈国华,杭燕萍,等.中西医结合治疗慢性呼吸衰竭临床研究.亚太传统医药,2017,13(4):96-97
[6]付跃峰,刘清泉,蔡阳平,等.AECOPD呼吸衰竭中医证素、症候的分布及与胃肠功能障碍相关研究.世界中医药,2014,9(3):265-274
[7]任建,敖素华.承气灌肠液联合无创通气治疗AECOPD呼吸衰竭的临床研究.世界最新医学信息文摘,2017,17(A2):4-6
[8]焦莉.慢性阻塞性肺病急性加重期呼吸衰竭中医辨治规范化研究.广州:广州中医药大学,2011:22-23
[9]钟章炼,梁锐记.参附注射液联合无创呼吸机治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的临床分析.中国现代药物应用,2017,11(21):111-113
[10]曾汇霞.急性呼吸衰竭的预后转归及证候趋势的观察.广州:广州中医药大学,2014:29-30
[11]刘良徛.洪广祥治喘脱证验案3则.江西中医药,2000,31(6):1-2