王立忠教授特发性水肿治验
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国家中医药管理局第三批全国优秀中医临床人才研修项目(编号:2012-2015);国家中医药管理局王立忠全国名老中医药专家传承工作室(编号:2012-2015);河南省中医管理局河南省中医临床学科领军人才培育计划(编号:201301006)


Professor Wang Lizhong’s Idiopathic Edema Treatment Experience
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    摘要:

    王立忠教授认为特发性水肿的发生与肝脾肾三脏关系十分密切,情志不畅,肝木不能条达,肝郁气滞,血不利而为水,泛溢肌肤,发为水肿。即气行则水行,气滞则水停。脾虚中阳不振,健运失司,气不化水,以致水邪泛滥。湿盛则阳微,湿邪阻遏阳气,肾阳亏虚,不能温煦,蒸腾气化失职,致使水湿泛滥肌肤、旁走四肢,阻滞气机,而成水肿脾肾阳虚证候。治疗常采用健脾益气、补肾温阳、化湿利水,疏肝解郁之法,以标本兼治。方剂选用济生肾气丸为主,加黄芪、党参、防己、茯苓皮、生白芍、赤小豆、冬瓜皮、陈皮、砂仁、生薏苡仁、炙甘草、大枣等药,有合用防己黄芪汤、五皮饮、四妙散之意,疗效较为显著。

    Abstract:

    Professor Wang Lizhong regards that idiopathic edema is due to disharmony of liver, spleen and kidney. Moodiness could induce stagnation in liver and qi. Therefore, blood stagnation forced water to flash in skin, which is edema. That is to say, qi could promote water movement, and qi stagnation result in water stagnation. if spleen is deficient, then middle yang would be insufficient, and the body will not have enough strength to digest food. Therefore, qi movement failed to promote water and then induce edema. Dampness in the body would consistently obstruct yang qi which is essential to warm kidney. When kidney yang was deficient, qi would fail to transform water and thus lead to water in extremities. This is why yang deficiency of kidney and spleen pattern was formed. To treat such disease, it is common to tonify spleen and qi, warm and supplement kidney and yang, resolve dampness and water, regulate liver and subsidy stagnation, which would treat the disease from root. Jisheng Shenqi pills was mainly used in medication. Accessory ingredients include Huangqi(Astragali radix), Dangshen(Codonopsis radix), Fangji(Stephaniae tetrandrae radix), Fulingpi(Poriae cutis), Shengbaishao( Radix paeoniae alba), Chixiaodou(Vignae Semen), Dongguapi(Benincasae exocarpium), Chenpi(Citri reticulatae pericarpium), Sharen(Amomi fructus), Shengyiren(Coisis Semen), Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle), Dazao(Jujubae fructus) and so on. If combined with Fangji Huangqi decoction, Wupi Yin and Simiao San, the efficacy would be promoted.

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王育勤,尹露.王立忠教授特发性水肿治验[J].世界中医药,2016,(02).

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  • 收稿日期:2015-04-29
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  • 在线发布日期: 2016-03-14
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