| 引用本文: |
符方智, 邱泽锐, 刘恒杰, 黄鑫, 周青.基于“病机三论”探讨慢性前列腺炎的治疗策略[J].湖南中医药大学学报,2025,45(3):491-495[点击复制] |
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| 基于“病机三论”探讨慢性前列腺炎的治疗策略 |
| 符方智,邱泽锐,刘恒杰,黄鑫,周青 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 基于王琦教授“病机三论”认识，总结分析慢性前列腺炎不同阶段的病机特点及经方治疗策略。慢性前列腺炎作为男性生殖泌尿系统常见疾病，其病程可分为初中期和后期。初中期病机以热毒蕴结为主，治法以清热解毒、利湿排浊为主，但应避免过度寒凉药物。此阶段以缓解Ⅱ型和ⅢA型慢性前列腺炎患者排尿不适症状为治疗目标，治疗可选用当归贝母苦参丸加滑石等类方，剂型以汤剂为主，发挥其药效迅速且可灵活加减的优势。后期病机以瘀浊互结为主，治法以活血化瘀、利湿排浊为主。此阶段以恢复ⅢB和Ⅳ型慢性前列腺炎患者前列腺正常生理状态为治疗目标，治疗可选用桂枝茯苓丸等类方，剂型以丸散剂为主，发挥药效持久且缓和的优势。愈后阶段则应遵循“无证候则辨体质”的诊疗原则，针对常见湿热质和血瘀质患者，配伍利湿、活血等药材或食材，制成药膳进行日常调养。 |
| 关键词: 慢性前列腺炎 经方 中药剂型 病机三论 病机特点 王琦 |
| DOI：10.3969/j.issn.1674-070X.2025.03.015 |
| 投稿时间：2024-10-07 |
| 基金项目:国家中医优势专科（外科）（国中医药医政函〔2024〕90号）；湖南省一类中医重点专科（男科）（湘中医药函〔2023〕4号）；湖南中医药大学研究生创新课题（2024CX016）。 |
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| Treatment strategies of chronic prostatitis based on “Three Theories of Pathogenesis” |
| FU Fangzhi, QIU Zerui, LIU Hengjie, HUANG Xin, ZHOU Qing |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Based on Professor WANG Qi's "Three Theories of Pathogenesis", this paper summarizes and analyzes the pathogenesis characteristics and treatment strategies using classical formulas for different stages of chronic prostatitis. Chronic prostatitis, a common disease of the male genitourinary system, can have its disease course divided into early-middle and late stages. In the early-middle stage, the pathogenesis is primarily characterized by the accumulation of heat and toxins. The treatment principle is to clear heat and remove toxins, as well as drain dampness and eliminate turbidity. However, the excessive use of cool and cold-natured medicines should be avoided. In this stage, the treatment goal is to alleviate urinary discomfort symptoms in patients with type Ⅱ and type ⅢA chronic prostatitis. Treatment can involve the use of modified formulas such as Danggui Beimu Kushen Pill with additions like Shigao (Gypsum Fibrosum), primarily in decoction form to leverage its rapid efficacy and the flexibility for adjustments. In the late stage, the pathogenesis is mainly characterized by the intertwined blood stasis and turbidity. The treatment principle is to circulate blood and transform stasis, as well as drain dampness and eliminate turbidity. The treatment goal in this stage is to restore the normal physiological state of the prostate in patients with type ⅢB and Ⅳ chronic prostatitis. Formulas such as Guizhi Fuling Pill and its modified formulas can be used, with pills or powders as the main dosage forms to leverage their advantages of sustained and mild therapeutic effects. During the recovery phase, the principle of "differentiating constitution when there are no symptoms" should be followed. For patients with common damp-heat and blood stasis constitutions, herbs or ingredients that circulate blood and drain dampness can be combined to prepare medicated diet for daily maintenance. |
| Key words: chronic prostatitis classical formulas dosage forms of Chinese medicines Three Theories of Pathogenesis pathogenesis characteristics WANG Qi |
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