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刘卓颖, 鲜馨蕾, 刘昱辛, 徐春英.基于“肝升肺降”理论探讨突发性聋的辨治[J].湖南中医药大学学报,2024,44(11):2126-2130[点击复制] |
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| 基于“肝升肺降”理论探讨突发性聋的辨治 |
| 刘卓颖,鲜馨蕾,刘昱辛,徐春英 |
| (中国中医科学院西苑医院, 北京 100091) |
| 摘要: |
| 升肺降”协调有序，是维持人体气机通畅的重要环节；肝肺升降失调，则气机紊乱，百病由生。突发性聋为耳鼻喉科危急重症之一，发展迅速，病机复杂，其发病与肝肺失调尤为密切。基于“肝升肺降”理论探讨突发性聋的病机，认为本病可分为虚实两型。虚证常因肝气不升，肺失宣发，耳窍失养，且易感风邪所致；实证多由金不制木，肺气不降，肝火亢逆，循经上蒙耳窍而致。临证时，虚证以养肝宣肺、升清开窍为主，实证以清金制木、敛肺平肝为主，随证配合祛风散邪、开窍通络等治法。以期及早截断病情发展，为临床治疗突发性聋提供新思路。 |
| 关键词: 突发性聋 肝升肺降 气机失调 祛风散邪 开窍通络 |
| DOI：10.3969/j.issn.1674－070X.2024.11.028 |
| 投稿时间：2024-06-05 |
| 基金项目:中国中医科学院科技创新工程项目（CI2021A02701）;中国中医科学院西苑医院名老中医经验传承研究专项项目（XYZX0101-34）。 |
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| Pattern differentiation and treatment of sudden deafness based on theory of "liver qi ascending and lung qi descending" |
| LIU Zhuoying, XIAN Xinlei, LIU Yuxin, XU Chunying |
| (Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China) |
| Abstract: |
| The coordination of liver qi ascending and lung qi descending ensures the free flow of qi in the human body, while the disharmony between them may result in qi disorders, thus leading to various diseases. Sudden deafness is one of the critical and severe conditions in otorhinolaryngology, characterized by rapid progression and complex pathogenesis. Its onset is particularly closely related to the disharmony between the liver and lungs. Based on the theory of "liver qi ascending and lung qi descending", this paper discusses the pathogenesis of sudden deafness and believes that this disease can be differentiated into two patterns: deficiency and excess. The deficiency pattern is mainly due to the failure of liver qi in ascending, resulting in the lung qi not being able to diffuse upward and outward, thus causing the malnourishment of the ears and making them susceptible to the pathogenic wind. The excess pattern is primarily caused by the failure of lung qi to descend, resulting in the inability to restrain the ascending liver qi (i.e. metal failing to restrict wood). This leads to hyperactive liver fire disturbing the ears along the meridians. In clinical practice, for the deficiency pattern, the treatment focuses on nourishing the liver and dispersing the lung qi, and upbearing nutrients to open the ear orifices; for the excess pattern, the treatment emphasizes astringing the lung qi and soothing the liver (i.e. clearing metal to restrict wood). Other therapies, such as dispelling wind, eliminating pathogens, opening the orifices, and unblocking the collaterals, should be tailored to the various symptoms. This paper aims to prevent the further development of sudden deafness at an early stage, and provide new ideas for the clinical treatment of this disease. |
| Key words: sudden deafness liver qi ascending and lung qi descending disordered qi activity dispelling wind and eliminating pathogens opening the orifices and unblocking the collaterals |
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