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高勇,李克亚,王真权.王真权教授运用复方芩柏汤治疗湿热蕴结型溃疡性结肠炎的临床经验[J].湖南中医药大学学报英文版,2023,43(1):132-137.[Click to copy
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| 王真权教授运用复方芩柏汤治疗湿热蕴结型溃疡性结肠炎的临床经验 |
| 高勇,李克亚,王真权 |
| (宁乡市人民医院, 湖南 宁乡 410600;湖南中医药大学第二附属医院, 湖南 长沙 410005) |
| 摘要: |
| 王真权教授认为溃疡性结肠炎急性活动期的病机关键在于“湿热”，“湿热”“气滞”“血瘀”贯穿溃疡性结肠炎急性活动期的全过程，治疗应以清热燥湿为主，行气止痛、化瘀止血为辅。强调：（1）辨病辨证相结合。辨病是基础，明确溃疡性结肠炎的疾病诊断后再辨证，才能抓住其本虚标实的特点，对其活动期和缓解期特点的认识更加准确，使治疗更加具体。（2）湿热蕴结是溃疡性结肠炎急性活动期的关键病机，湿热即是重要病因，也是急性活动期致病的关键病机。（3）清热燥湿、顺势而为是溃疡性结肠炎急性活动期的关键治法。溃疡性结肠炎急性活动期发病初期以湿热蕴结为主，而后湿阻气机，瘀滞肠腑以致于血败肉腐。故临证之时应以清热燥湿为本，以调和气血为辅，祛除湿热之关键病因，断瘀血之来路，如此顺势而为，防止病情进一步进展。（4）衷中参西、内外合治是溃疡性结肠炎急性活动期的重要治疗手段。通过中医辨证论治，将复方芩柏汤颗粒剂通过口服和（或）保留灌肠的方式使药物直达病所，改善黏膜屏障，修复病变黏膜，以达到治疗的目的。 |
| 关键词: 溃疡性结肠炎 复方芩柏汤 王真权 湿热蕴结 辨证论治 临床经验 医案 |
| DOI：10.3969/j.issn.1674-070X.2023.01.021 |
| Received:May 23, 2022 |
| 基金项目:湖南省中医药管理局项目(2021020)；长沙市自然科学基金项目（kq2202482）；湖南省自然科学基金项目（S2012J5043）；湖南省中医药管理局一般项目（201786）。 |
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| Professor WANG Zhenquan's experience in treating ulcerative colitis of damp-heat accumulation pattern with Compound Qinbo Decoction |
| GAO Yong,LI Keya,WANG Zhenquan |
| (People's Hospital of Ningxiang, Ningxiang, Hunan 410600, China;The Second Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410005, China) |
| Abstract: |
| Professor WANG Zhenquan believes damp heat is the critical pathogenesis in the acute active stage of ulcerative colitis, and the damp heat exists throughout the stage with qi stagnation and blood stasis. The treatment should be clearing heat and drying dampness, supplemented by circulating qi, relieving pain, transforming stasis and stopping bleeding. He emphasizes as followed. Firstly, combine disease differentiation with pattern differentiation, with disease differentiation as the foundation. The key features of deficient root and excess tip can be known more accurately and treated more specifically in both active and remission stages when identifying the patterns are identified after definite diagnosis of ulcerative colitis. Secondly, in the acute active stage of ulcerative colitis, damp-heat accumulation is the critical pathogenesis because damp heat is both the key etiology and pathogenesis. Thirdly, the key method is to clear heat, dry dampness and follow the progress. In the early acute active stage, damp-heat accumulation is the main pathogenesis followed by obstructed qi activity due to dampness, leading to stasis obstruction in the intestine and bloody abscess. So, he mainly treats by clearing heat and drying dampness, supplemented by harmonizing qi and blood in order to get rid of the key pathogen, damp heat, which may avoid the static blood. Such is the way to follow the progress of pathogenesis and to prevent development. Fourthly, the vital therapy is to integrate Chinese and western medicine and to combine oral administration and external application. Based on pattern differentiation, Compound Qinbo Decoction granule is taken both by oral administration and retention enema so that it can get to the diseased area directly, then improve the mucosal barrier and repair diseased mucosa, and finally cure the disease. |
| Key words: ulcerative colitis Compound Qinbo Decoction WANG Zhenquan damp-heat accumulation treatment based on pattern differentiation clinical experience medical case |
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