秦国政从血论治带状疱疹经验
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摘要
秦国政教授认为"风"为带状疱疹的首发病因,由"血"生"风"是本病基本病机,治疗应遵循"治风先治血,血行风自灭"的原则,由"血"治"风"。血热者以清热凉血为主,血瘀者以活血化瘀为主,血虚者以养血活血为主,使血行风灭,其症自消。秦国政教授以名方温清饮为主方,根据病程分期及患者临床症状加减用药,急性发作期属外感风热证者在运用温清饮的同时加入麻黄、桂枝、牛蒡子、蝉蜕、紫草等药物以解表退热,透邪外出;属肝经郁热证者在温清饮基础上加入珍珠母、地龙、紫草等药物以清热平肝;属湿热内蕴证者在温清饮的基础上加入泽泻、山栀子等药物以清热利湿。缓解期属气滞血瘀证者在温清饮基础上加丹参、仙鹤草、黄芪、甘草等药物以活血益气补虚;属气血虚弱证者加生黄芪、生甘草、炒麦芽、砂仁等药物以顾护正气。此外秦国政教授还十分注重药物外治,药用丝瓜络,烧灰存性,醋调外涂于患处,取得了较好的疗效。
Professor Qin Guo-zheng believes that " wind" is the first cause of herpes zoster. The basic pathogenesis of this disease is that blood produces wind. The treatment should follow the principle of " treating wind first,to treat blood circulation",because flowing blood leads to disappearance of wind. For excessive blood heat,clearing away heat and cooling blood is focused. For blood stasis,promoting blood circulation and removing blood stasis is focused. For blood deficiency,nourishing blood and promoting blood circulation is focused. Professor Qin Guo-zheng uses Decoction for Warming and Clearing Heat as the main formula,and modifies its ingredients according to the stages of the disease and the clinical symptoms of the patients. For the patients with exogenous wind-heat syndrome in the acute attack stage,Mahuang( Herba Ephedrae),Guizhi( Ramulus Cinnamomi),Niubangzi( Fructus Arctii),Chantui( Periostracum Cicadae),Zicao( Radix Arnebiae) are also added to relieve exterior symptoms and remove fever,expel pathogenic fators from the superficies. For the ones with the syndrome of stagnated fire of liver meridian,Zhenzhumu( Concha Margaritiferae Usta),Dilong( Pheretima),Zicao( Radix Arnebiae) are also added to clear away heat and calm the liver. For the ones with the syndrome of accumulation of damp and heat,Zexie( Rhizoma Alismatis) and Shanzhizi( Fructus Gardeniae) are also added to clear away heat and remove dampness. In the remission stage,for the patients with qi stagnation and blood stasis,Danshen( Radix et Rhizoma Salviae Miltiorrhizae),Xianhecao( Herba Agrimoniae),Huangqi( Radix Astragali),Gancao( Radix et Rhizoma Glycyrrhizae) are also added to invigorate the circulation of blood and replenish qi and deficiency. For the ones with qi-blood deficiency,raw Huangqi( Radix Astragali),raw Gancao( Radix et Rhizoma Glycyrrhizae),fried Maiya( Fructus Hordei Germinatus),Sharen( Fructus Amomi) are also added to strengthen healthy qi. Besides,Professor Qin attaches great importance to the external treatment of drugs,for example,Sigualuo is often fried into dashes and mixed with vinegar to apply to the affected area,which has always achieved good results.
Professor Qin Guo-zheng believes that " wind" is the first cause of herpes zoster. The basic pathogenesis of this disease is that blood produces wind. The treatment should follow the principle of " treating wind first,to treat blood circulation",because flowing blood leads to disappearance of wind. For excessive blood heat,clearing away heat and cooling blood is focused. For blood stasis,promoting blood circulation and removing blood stasis is focused. For blood deficiency,nourishing blood and promoting blood circulation is focused. Professor Qin Guo-zheng uses Decoction for Warming and Clearing Heat as the main formula,and modifies its ingredients according to the stages of the disease and the clinical symptoms of the patients. For the patients with exogenous wind-heat syndrome in the acute attack stage,Mahuang( Herba Ephedrae),Guizhi( Ramulus Cinnamomi),Niubangzi( Fructus Arctii),Chantui( Periostracum Cicadae),Zicao( Radix Arnebiae) are also added to relieve exterior symptoms and remove fever,expel pathogenic fators from the superficies. For the ones with the syndrome of stagnated fire of liver meridian,Zhenzhumu( Concha Margaritiferae Usta),Dilong( Pheretima),Zicao( Radix Arnebiae) are also added to clear away heat and calm the liver. For the ones with the syndrome of accumulation of damp and heat,Zexie( Rhizoma Alismatis) and Shanzhizi( Fructus Gardeniae) are also added to clear away heat and remove dampness. In the remission stage,for the patients with qi stagnation and blood stasis,Danshen( Radix et Rhizoma Salviae Miltiorrhizae),Xianhecao( Herba Agrimoniae),Huangqi( Radix Astragali),Gancao( Radix et Rhizoma Glycyrrhizae) are also added to invigorate the circulation of blood and replenish qi and deficiency. For the ones with qi-blood deficiency,raw Huangqi( Radix Astragali),raw Gancao( Radix et Rhizoma Glycyrrhizae),fried Maiya( Fructus Hordei Germinatus),Sharen( Fructus Amomi) are also added to strengthen healthy qi. Besides,Professor Qin attaches great importance to the external treatment of drugs,for example,Sigualuo is often fried into dashes and mixed with vinegar to apply to the affected area,which has always achieved good results.
引文
[1]崔长弘.带状疱疹流行病学特征及预防策略研究现状[J].疾病监测,2013,28(12):1030-1034.
[2]李娟,索罗丹,赵丹,等.带状疱疹的流行病学研究进展[J].现代预防医学,2014,41(5):781-784.
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[5]SCHMADER K.Postherpetic neuralgia in immunocompetent elderly People[J].Vaccine,1998,16(18):1768-1770.
[6]CHOO P W,GALIL K,DONAHUE J G,et al.Risk factors for postherpetic neuralgia[J].Arch Intern Med,1997,157(11):1217-1224.
[7]于生元,万有,万琪,等.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22(3):161-167.
[8]周冬梅,陈维文.蛇串疮中医诊疗指南(2014年修订版)[J].中医杂志,2015,56(13):1163-1168.
[9]王丽昆,岳海龙,毕廷民,等.活血化瘀法治疗老年带状疱疹后遗神经痛的临床研究[J].辽宁中医杂志,2016,43(2):301-303.
[10]秦丽娟,付于.针灸治疗带状疱疹后遗神经痛文献综述[J].河南中医,2012,32(2):250-252.
[11]张燕梅,何念善,吴兰珍.火针结合刺络拔罐治疗带状疱疹后遗神经痛36例[J].河南中医,2016,36(1):142-143.
[12]杜旭,刘爱民.古方温清饮现代药理与临床应用研究进展[J].中国中医药科技,2008,15(5):399-400.
[13]秦国政.温清饮在皮肤病中的新用途[J].云南中医杂志,1990,11(1):31-32.
[14]YAWN B P,SADDIER P,WOLLAN P C,et al.A populationbased study of the incidence and complication rates of herpes zoster before zoster vaccine introduction[J].Mayo Clin Proc,2007,82(11):1341-1349.
[15]GONZALEZ CHIAPPE S,SARAZIN M,TURBELIN C,et al.Herpes zoster:burden of disease in France[J].Vaccine,2010,28(50):7933-7938.
[16]PERGAM S A,FORSBERG C W,BOECKH M J,et al.Herpes Zoster incidence in a multicenter cohortof solid organ transplantrecipients[J].Transpl Infect Dis,2011,13(1):15-23.
[17]GEBO K A,KALYANI R,MOORE R D,et al.The incidence of,risk factors fo,and sequelae of herpes zoster among HIV patients in the highly active antiretroviral therapy era[J].Jaids-J Acq Imm Def,2005,40(2):169-174.
[18]孙小勇,秦国政,袁卓珺,等.秦国政教授治疗男性免疫性不育症经验总结[J].广西中医药,2012,35(4):42-44.
[19]KIM J J,JIANG J,SHIM D W,et al.Anti-inflammatory and antiallergic effects of Agrimonia pilosa Ledeb.extract on murine cell lines and OVA-induced airway inflammation[J].Journal of Ethnopharmacology,2012,140(2):213-221.
[20]龙启才,邱建波.威灵仙、秦艽、桑寄生醇提物体外对淋巴细胞和环氧酶的影响[J].中药药理与临床,2004,20(4):26-27.
[21]杨丽,刘友平,韦正,等.贝壳类药材牡蛎石决明珍珠母的研究进展[J].时珍国医国药,2013,24(12):2990-2992.
[22]杨花,高昂,赵兵,等.丝瓜络药学研究概况[J].安徽农业科学,2011,39(34):20990-20991.
[23]雷利锋.速效救心丸治疗带状疱疹临床体会[J].中国中医急症,2010,19(1):142-143.
[24]张波.内服外敷速效救心丸治疗带状疱疹[J].中国民间疗法,2008,16(7):34.
[25]肖培根.新编中药志[M].北京:化学工业出版社,2002:929.
[2]李娟,索罗丹,赵丹,等.带状疱疹的流行病学研究进展[J].现代预防医学,2014,41(5):781-784.
[3]KOST R G,STRAUS S E.Postherpetic neuralgia--pathogenesis,treatment,and prevention[J].N Engl Med,1996,335(1):32-42.
[4]VAN HECKE O,AUSTIN S K,KHAN R A,et al.Neuropathic pain in the general population:a systematic review of epidemiological studies[J].Pain,2014,155(6):654-662.
[5]SCHMADER K.Postherpetic neuralgia in immunocompetent elderly People[J].Vaccine,1998,16(18):1768-1770.
[6]CHOO P W,GALIL K,DONAHUE J G,et al.Risk factors for postherpetic neuralgia[J].Arch Intern Med,1997,157(11):1217-1224.
[7]于生元,万有,万琪,等.带状疱疹后神经痛诊疗中国专家共识[J].中国疼痛医学杂志,2016,22(3):161-167.
[8]周冬梅,陈维文.蛇串疮中医诊疗指南(2014年修订版)[J].中医杂志,2015,56(13):1163-1168.
[9]王丽昆,岳海龙,毕廷民,等.活血化瘀法治疗老年带状疱疹后遗神经痛的临床研究[J].辽宁中医杂志,2016,43(2):301-303.
[10]秦丽娟,付于.针灸治疗带状疱疹后遗神经痛文献综述[J].河南中医,2012,32(2):250-252.
[11]张燕梅,何念善,吴兰珍.火针结合刺络拔罐治疗带状疱疹后遗神经痛36例[J].河南中医,2016,36(1):142-143.
[12]杜旭,刘爱民.古方温清饮现代药理与临床应用研究进展[J].中国中医药科技,2008,15(5):399-400.
[13]秦国政.温清饮在皮肤病中的新用途[J].云南中医杂志,1990,11(1):31-32.
[14]YAWN B P,SADDIER P,WOLLAN P C,et al.A populationbased study of the incidence and complication rates of herpes zoster before zoster vaccine introduction[J].Mayo Clin Proc,2007,82(11):1341-1349.
[15]GONZALEZ CHIAPPE S,SARAZIN M,TURBELIN C,et al.Herpes zoster:burden of disease in France[J].Vaccine,2010,28(50):7933-7938.
[16]PERGAM S A,FORSBERG C W,BOECKH M J,et al.Herpes Zoster incidence in a multicenter cohortof solid organ transplantrecipients[J].Transpl Infect Dis,2011,13(1):15-23.
[17]GEBO K A,KALYANI R,MOORE R D,et al.The incidence of,risk factors fo,and sequelae of herpes zoster among HIV patients in the highly active antiretroviral therapy era[J].Jaids-J Acq Imm Def,2005,40(2):169-174.
[18]孙小勇,秦国政,袁卓珺,等.秦国政教授治疗男性免疫性不育症经验总结[J].广西中医药,2012,35(4):42-44.
[19]KIM J J,JIANG J,SHIM D W,et al.Anti-inflammatory and antiallergic effects of Agrimonia pilosa Ledeb.extract on murine cell lines and OVA-induced airway inflammation[J].Journal of Ethnopharmacology,2012,140(2):213-221.
[20]龙启才,邱建波.威灵仙、秦艽、桑寄生醇提物体外对淋巴细胞和环氧酶的影响[J].中药药理与临床,2004,20(4):26-27.
[21]杨丽,刘友平,韦正,等.贝壳类药材牡蛎石决明珍珠母的研究进展[J].时珍国医国药,2013,24(12):2990-2992.
[22]杨花,高昂,赵兵,等.丝瓜络药学研究概况[J].安徽农业科学,2011,39(34):20990-20991.
[23]雷利锋.速效救心丸治疗带状疱疹临床体会[J].中国中医急症,2010,19(1):142-143.
[24]张波.内服外敷速效救心丸治疗带状疱疹[J].中国民间疗法,2008,16(7):34.
[25]肖培根.新编中药志[M].北京:化学工业出版社,2002:929.