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石维文, 杜旭, 殷克敬, 李敏.殷克敬基于“肝郁-脾虚-肾亏”病机链治疗肉芽肿性乳腺炎经验[J].湖南中医药大学学报,2026,46(3):622-627[点击复制] |
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| 殷克敬基于“肝郁-脾虚-肾亏”病机链治疗肉芽肿性乳腺炎经验 |
| 石维文,杜旭,殷克敬,李敏 |
| (陕西中医药大学, 陕西 咸阳 712046;陕西中医药大学第二附属医院殷克敬工作室, 陕西 咸阳 712099) |
| 摘要: |
| 名老中医殷克敬教授从中医整体观出发，认为肉芽肿性乳腺炎（GM）的病机为肝失疏泄、脏腑失调，并依据本病发生发展规律，创新性地提出“肝郁-脾虚-肾亏”动态病机链。殷克敬教授指出，该病机链呈现出一个由功能失调到物质亏损、由气及血、最终痰瘀胶结的渐进演变过程。始动在肝，情志不畅或压力导致肝气郁结，此为病机起点；关键在脾，肝郁克脾，导致脾失健运；根本在肾，病程迁延或素体不足，穷必及肾。治疗上，遵循“疏肝调枢，调养脏腑”的总纲，分期辨治。肝郁核心期：疏肝解郁、理气散结，以挫其势；脾虚演进期：健脾化痰、扶正托毒，以固其本；肾亏迁延期：温肾填精、固本防复，以善其后。形成针、灸、药协同的治疗方案，共同改善体质，防止复发。附临床验案一则，以期为中医治疗本病提供参考经验。 |
| 关键词: 肉芽肿性乳腺炎 “肝郁-脾虚-肾亏”病机链 针灸药结合 名医经验 殷克敬 |
| DOI：10.3969/j.issn.1674-070X.2026.03.026 |
| 投稿时间：2025-10-10 |
| 基金项目:全国名老中医传承工作室建设项目（国中医药人教发〔2011〕41 号）。 |
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| YIN Kejing's experience in treating granulomatous mastitis based on the pathogenesis chain of "liver qi stagnation-spleen deficiency-kidney deficiency" |
| SHI Weiwen, DU Xu, YIN Kejing, LI Min |
| (Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712046, China;Yin Kejing Studio, Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712099, China) |
| Abstract: |
| Drawing on the holistic perspective of Chinese medicine, professor YIN Kejing, a Renowned TCM Physician, posits that the pathogenesis of granulomatous mastitis (GM) lies in the liver's failure in governing the free flow of qi and disharmony of the zang-fu organs. In accordance with the pattern of the onset and progression of this disease, he innovatively proposes a dynamic pathogenesis chain of "liver qi stagnation-spleen deficiency-kidney deficiency". Professor YIN points out that this pathogenesis chain represents a progressive evolution from functional disharmony to material deficiency, from qi to blood, and ultimately resulting in the congealing of phlegm and stasis. The initiation occurs in the liver, where emotional distress or stress leads to liver qi stagnation, marking the starting point of the pathogenesis. The key lies in the spleen, as the liver depression restrains the spleen, causing impaired spleen function. The root cause resides in the kidney, where prolonged disease course or constitutional insufficiency inevitably involves the kidney. The treatment follows the general principle of soothing the liver, regulating the pivot, as well as regulating and nourishing zang-fu organs, and is implemented by staged pattern differentiation and treatment. During the core stage of liver qi stagnation, the approach involves soothing the liver and resolving depression, regulating qi, and resolving masses to curb its momentum. During the progressive stage of spleen deficiency, the focus is on strengthening the spleen, transforming phlegm, reinforcing the healthy qi and expelling toxins to strengthen the body. During the prolonged stage of kidney deficiency, the treatment aims to warm the kidneys, replenish essence, strengthen the body, and prevent recurrence to ensure recovery. This forms an integrated treatment protocol combining acupuncture, moxibustion, and herbal medicine to collectively improve constitution and prevent recurrence. A verified clinical medical record is provided to offer a reference for the TCM treatment of this disease. |
| Key words: granulomatous mastitis pathogenesis chain of "liver qi stagnation-spleen deficiency-kidney deficiency" combination of acupuncture, moxibustion, and herbal medicine famous doctors' experience YIN Kejing |
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