中医药治疗重症肌无力简况
|
摘要
重症肌无力归属为"痿证""睑废""大气下陷"等范畴,"五脏使人痿",分为"痿蹙""脉痿""筋痿""肉痿""骨痿"等,以脾胃虚损为主,兼有肝肾气血亏虚或湿热、风邪等外邪侵犯;病位在筋脉肌肉,根本在于五脏虚损,以脾胃、肝、肾等脏腑最为常见;病性以热证、虚证为多,以虚为本。扶正补虚,兼以祛邪,"治痿独取阳明",古方补中益气汤、二妙汤等;自拟方有复肌宁汤、滋肾调肝汤;中成药强肌健力饮、黄芪复方颗粒;其它疗法如针灸、温针、电针、隔物灸等,都有良好的效果。经典名方运用、辨证分型、疗效标准无统一规范,自拟方缺乏严格对照和统计分析,中成药方药固定、治疗证型单一,中医外治法接受度高,疗效与操作手法、临床经验有关,有待系统性规范和拓展。
Myasthenia gravis belongs to "Weizheng(痿证)","Jianfei(睑废)" and "Daqi Xiaxian(大气下陷)","Category.Five internal organs makes people Wei(痿)" divided into "Weicu(痿蹙)","Maiwei(脉痿)","Jinwei(筋痿)","Rouwei(肉痿)" and "Guwei(骨痿)" etc.It is mainly spleen and stomach depletion,and it also has liver and kidney Qi and blood deficiency,and Shire(湿热),wind and other evils invasion.The disease is located in the Jinmai(筋脉) and muscles.The main problem lies in the loss of the five organs,the spleen,stomach,liver,and kidneys are the most common.The disease is based on hot syndrome and deficiency syndrome more,mainly based on deficiency syndrome.The cure for the disease is Fuzheng Buxu(扶正补虚)and getting rid of evils."The method of treating Weizheng(痿证) is to take Yangming".For example,ancient classic prescriptions such as Buzhong Yiqi decoction(补中益气汤),Ermiao decoction(二妙汤),etc;selfmade prescriptions Fujining decoction(复肌宁汤) and Zishen Tiaogan decoction(滋肾调肝汤); Chinese patent medicines Qiangji Jianli Yin(强肌健力饮) and astragalus compound granules; other treatments such as acupuncture,warm-acupuncture,electro-acupuncture,moxibustion,etc.have good results.But there are no uniform standards for the use of classic prescriptions,syndrome differentiation and efficacy standard.And self-made prescriptions lack rigorous controlled studies and statistical analysis.Also Chinese patent medicines are formulas fixed and the treatment of syndromes limitations.Although the external treatment of traditional Chinese medicine is highly accepted,the efficacy and operation methods are related to clinical experience and need to be systematically standardized and expanded.
Myasthenia gravis belongs to "Weizheng(痿证)","Jianfei(睑废)" and "Daqi Xiaxian(大气下陷)","Category.Five internal organs makes people Wei(痿)" divided into "Weicu(痿蹙)","Maiwei(脉痿)","Jinwei(筋痿)","Rouwei(肉痿)" and "Guwei(骨痿)" etc.It is mainly spleen and stomach depletion,and it also has liver and kidney Qi and blood deficiency,and Shire(湿热),wind and other evils invasion.The disease is located in the Jinmai(筋脉) and muscles.The main problem lies in the loss of the five organs,the spleen,stomach,liver,and kidneys are the most common.The disease is based on hot syndrome and deficiency syndrome more,mainly based on deficiency syndrome.The cure for the disease is Fuzheng Buxu(扶正补虚)and getting rid of evils."The method of treating Weizheng(痿证) is to take Yangming".For example,ancient classic prescriptions such as Buzhong Yiqi decoction(补中益气汤),Ermiao decoction(二妙汤),etc;selfmade prescriptions Fujining decoction(复肌宁汤) and Zishen Tiaogan decoction(滋肾调肝汤); Chinese patent medicines Qiangji Jianli Yin(强肌健力饮) and astragalus compound granules; other treatments such as acupuncture,warm-acupuncture,electro-acupuncture,moxibustion,etc.have good results.But there are no uniform standards for the use of classic prescriptions,syndrome differentiation and efficacy standard.And self-made prescriptions lack rigorous controlled studies and statistical analysis.Also Chinese patent medicines are formulas fixed and the treatment of syndromes limitations.Although the external treatment of traditional Chinese medicine is highly accepted,the efficacy and operation methods are related to clinical experience and need to be systematically standardized and expanded.
引文
[1]中国免疫学会神经免疫学分会,中华医学会神经病学会神经免疫学组.重症肌无力诊断和治疗中国专家共识[J].中国神经免疫学和神经病学杂志,2012,19(6):401-408.
[2]贾建平,陈生弟.神经病学[M].7版.北京:人民卫生出版社,2013:365-366.
[3]邓中光,邱仕君,邓铁涛.邓铁涛对重症肌无力的认识与辨证论治[J].中华中医药杂志,1993(2):41-43.
[4]王庆其.内经选读[M].2版.北京:中国中医药出版社,2007.
[5]巢元方.诸病源候论[M].北京:中国医药科技出版社,2011,3.
[6]叶天士.临证指南医案[M].北京:人民卫生出版社,2006:339.
[7]朱丹溪.格致余论局方发挥[M].北京:中国医药科技出版社,2011:70.
[8]盛昭园,陈钢,董云,等.李庚和重症肌无力诊治经验[J].辽宁中医杂志,2013,40(6):1084-1085.
[9]蒋旭宏,黄小民,章正祥,等.裘昌林教授治疗重症肌无力的用药规律探究[J].中国中医急症,2016,25(3):428-432.
[10]张艳玲.随尚尔寿从肝风论治重症肌无力的体会[J].内蒙古中医药,2014,33(19):33.
[11]刘雪景.补中益气汤治疗重症肌无力临床观察[J].中医临床研究,2017,9(23):54-55.
[12]娄金波,李霞,陈永华.加味二妙汤治疗痿证(湿热浸淫型)30例临床疗效[J].黔南民族医专学报,2017,30(2):102-103,113.
[13]卡佳,顼宝玉,陈乐君,等.复肌宁汤对眼肌型重症肌无力病人免疫学指标的调控研究[J].中西医结合心脑血管病杂志,2016,14(7):688-690.
[14]胡国恒,李映辰,邹婷.滋肾调肝汤治疗重症肌无力的临床研究[J].中华中医药学刊,2016,34(3):522-524.
[15]黄子天,刘小斌.国医大师邓铁涛强肌健力饮治疗重症肌无力的临床应用及学术传承[J].广州中医药大学学报,2018,35(1):182-185.
[16]鲍波,张静生,乔文军.加用黄芪复方颗粒治疗重症肌无力临床观察[J].广西中医药大学学报,2016,19(1):13-15.
[17]盛昭园,陈钢,胡智海,等.温针灸配合中药治疗眼肌型重症肌无力临床观察[J].上海针灸杂志,2015,34(6):540-542.
[18]王文同,刘竹丽.中医外治法治疗重症肌无力30例临床观察[J].中医临床研究,2017,9(2):85-86.
[2]贾建平,陈生弟.神经病学[M].7版.北京:人民卫生出版社,2013:365-366.
[3]邓中光,邱仕君,邓铁涛.邓铁涛对重症肌无力的认识与辨证论治[J].中华中医药杂志,1993(2):41-43.
[4]王庆其.内经选读[M].2版.北京:中国中医药出版社,2007.
[5]巢元方.诸病源候论[M].北京:中国医药科技出版社,2011,3.
[6]叶天士.临证指南医案[M].北京:人民卫生出版社,2006:339.
[7]朱丹溪.格致余论局方发挥[M].北京:中国医药科技出版社,2011:70.
[8]盛昭园,陈钢,董云,等.李庚和重症肌无力诊治经验[J].辽宁中医杂志,2013,40(6):1084-1085.
[9]蒋旭宏,黄小民,章正祥,等.裘昌林教授治疗重症肌无力的用药规律探究[J].中国中医急症,2016,25(3):428-432.
[10]张艳玲.随尚尔寿从肝风论治重症肌无力的体会[J].内蒙古中医药,2014,33(19):33.
[11]刘雪景.补中益气汤治疗重症肌无力临床观察[J].中医临床研究,2017,9(23):54-55.
[12]娄金波,李霞,陈永华.加味二妙汤治疗痿证(湿热浸淫型)30例临床疗效[J].黔南民族医专学报,2017,30(2):102-103,113.
[13]卡佳,顼宝玉,陈乐君,等.复肌宁汤对眼肌型重症肌无力病人免疫学指标的调控研究[J].中西医结合心脑血管病杂志,2016,14(7):688-690.
[14]胡国恒,李映辰,邹婷.滋肾调肝汤治疗重症肌无力的临床研究[J].中华中医药学刊,2016,34(3):522-524.
[15]黄子天,刘小斌.国医大师邓铁涛强肌健力饮治疗重症肌无力的临床应用及学术传承[J].广州中医药大学学报,2018,35(1):182-185.
[16]鲍波,张静生,乔文军.加用黄芪复方颗粒治疗重症肌无力临床观察[J].广西中医药大学学报,2016,19(1):13-15.
[17]盛昭园,陈钢,胡智海,等.温针灸配合中药治疗眼肌型重症肌无力临床观察[J].上海针灸杂志,2015,34(6):540-542.
[18]王文同,刘竹丽.中医外治法治疗重症肌无力30例临床观察[J].中医临床研究,2017,9(2):85-86.