王世轩续筋接骨方四法分期辨治创伤骨折
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摘要
王世轩教授认为骨折可引起气血失衡、痹阻,难以通流全身,表现出肿痛和功能障碍,也会出现崎形、骨擦音、异常活动等。前期实为血瘀气滞兼加水湿,后期以机体虚损为主,故理气化瘀为前期治疗首选,后期以补肝益肾为主,提出筋骨并重、动静结合、内外兼治、医患合作四法。创立续筋接骨方兼顾骨折前后期,化瘀祛水、通络补虚。四诊合参、辨证论治,辨明虚实,活血化瘀、理气通络,体质不同,症状各异,临证既要抓住骨折根源,亦应据兼证变化加减,才能药到病除。附右第一跖骨干骨折(血瘀气滞)验案1则。
Professor WANG Shixuan believes that fracture can cause disorder of Qi-blood,obstruction, Qi and blood can hardly flow through the whole body, showing gall and dysfunction, the malformation of bone and abnormal activities. In the early stage, the stagnation of qi and blood and the retention of water could caused disease. in the later stage, it is mainly accompanied by deficiency of the body. so the first choice for early treatment for activating blood circulation, and late to use medicine with invigorating liver and kidney.Therefore, The professor WANG put forward four kinds of methods:emphasis on both sinews and bones,association of activity and inertia, treatment with internal and external and the practical doctor-patient interaction. the prescription of reinforcing tendons and bones is developed by professor Wang based on his medical experience for many years. This prescription has the effect of removing blood stasis and the retention of water. It also dredges the channels and collaterals, invigorating the spleen and relieving pain.Though emphasizing combined use of the four diagnostic methods and treating based on syndrome differentiation,Professor WANG can grasp the root of fracture treatment and combine several prescriptions guided by the idea of therapy with syndrome differentiation to promote blood circulation and smooth circulation. Case one of the right first metatarsal shaft fracture(the type of Qi stagnancy and blood stasis)
Professor WANG Shixuan believes that fracture can cause disorder of Qi-blood,obstruction, Qi and blood can hardly flow through the whole body, showing gall and dysfunction, the malformation of bone and abnormal activities. In the early stage, the stagnation of qi and blood and the retention of water could caused disease. in the later stage, it is mainly accompanied by deficiency of the body. so the first choice for early treatment for activating blood circulation, and late to use medicine with invigorating liver and kidney.Therefore, The professor WANG put forward four kinds of methods:emphasis on both sinews and bones,association of activity and inertia, treatment with internal and external and the practical doctor-patient interaction. the prescription of reinforcing tendons and bones is developed by professor Wang based on his medical experience for many years. This prescription has the effect of removing blood stasis and the retention of water. It also dredges the channels and collaterals, invigorating the spleen and relieving pain.Though emphasizing combined use of the four diagnostic methods and treating based on syndrome differentiation,Professor WANG can grasp the root of fracture treatment and combine several prescriptions guided by the idea of therapy with syndrome differentiation to promote blood circulation and smooth circulation. Case one of the right first metatarsal shaft fracture(the type of Qi stagnancy and blood stasis)
引文
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[19]何娟,刘万方,刘春丽,王海洋,陈盼,汤小虎.导师运用四妙丸加味治疗痹证的验案举隅[J].云南中医中药杂志,2018,39(07):36-37.
[20]李翼.方剂学[M].北京:高等教育出版社,2009:164.
[2]王世轩,李国信.中医骨伤病诊疗实战技术[M].沈阳:沈阳出版社,2017:1.
[3]李国信,王世轩.软伤病中医特色疗法[M].沈阳:辽宁科学技术出版社,2016:1.
[4]季顺欣,傅海燕.《正体类要·正体主治大法》的骨科内伤病诊疗理论研究[J].中国中医骨伤科杂志,2016,24(2):76-78.
[5]陈宇谨.唐容川《血证论》学术思想研究[D].北京:中国中医科学院,2008.
[6]孙封峰.接骨丹对上肢闭合性骨折患者术后愈合情况的影响[D].济南:山东中医药大学,2015.
[7]汪福武汪子栋.骨折中医正骨辨证论治[J].中国中医药现代远程教育,2016,14(20):41-43.
[8]杨冬辉.筋骨并重、医患合作”理论在青年颈型颈椎病防治中应用的临床研究[D].广州:广州中医药大学,2016.
[9]曹琳琰,张淼.临床医患对话中合作原则违背现象解析[J].中医药导报,2015,21(19):105-107.
[10]高学敏.中药学[M].北京:中国中医药出版社,2007.
[11]刘思伟.乳香治痛经[J].中国乡村医药,1996(7):46.
[12]李贤清.中药乳香没药散治疗马骡骨折[J].青海畜牧兽医杂志,2006(3):18.
[13]田同良.张锡纯治疗中风病方剂研究[D].南京:南京中医药大学,2009.
[14]陈亚平,关枫.传统中药当归[J].中医药信息,2016,33(4):44-46.
[15]刘映岐.菟丝子治疗膝骨性关节炎实验及临床验证研究[D].成都:成都中医药大学,2017.
[16]杨金维.杜仲对去势骨质疏松大鼠骨生物力学、骨密度及相关指标影响的实验研究[D].南京:南京中医药大学,2010.
[17]杨琳.从OPG/RANKL/细胞因子网络探讨补骨脂素抗绝经后骨质疏松作用机制[D].长沙:湖南中医药大学,2016.
[18]陆韵薇.生地黄水煎剂对H2O2介导大鼠肾上腺髓质嗜铬细胞瘤细胞PC-12体外凋亡的影响[D].南京:南京中医药大学,2017.
[19]何娟,刘万方,刘春丽,王海洋,陈盼,汤小虎.导师运用四妙丸加味治疗痹证的验案举隅[J].云南中医中药杂志,2018,39(07):36-37.
[20]李翼.方剂学[M].北京:高等教育出版社,2009:164.