[1]刘博文,李晓斌,马贵萍,等.名中医胡世平运用“培养、招纳、解散”三法治疗慢性肝病腹水经验[J].陕西中医,2024,(6):812-814,819.[doi:DOI:10.3969/j.issn.1000-7369.2024.06.019]
 LIU Bowen,LI Xiaobin,MA Guiping,et al.Experience of Hu Shiping in treating ascites in chronic liver disease with the three methods of “cultivation,recruitment and dissolution”[J].,2024,(6):812-814,819.[doi:DOI:10.3969/j.issn.1000-7369.2024.06.019]
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名中医胡世平运用“培养、招纳、解散”三法治疗慢性肝病腹水经验
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年6期
页码:
812-814,819
栏目:
名中医经验
出版日期:
2024-06-05

文章信息/Info

Title:
Experience of Hu Shiping in treating ascites in chronic liver disease with the three methods of “cultivation,recruitment and dissolution”
作者:
刘博文1李晓斌1马贵萍2仪 凡1李 峰1胡世平2
[1.北京中医药大学,北京 100105; 2.北京中医药大学深圳医院(龙岗),广东 深圳 518172]
Author(s):
LIU BowenLI XiaobinMA GuipingYI FanLI FengHU Shiping
(Beijing University of Chinese Medicine,Beijing 100105,China)
关键词:
肝硬化 腹水 单腹胀 腹水治脾 大补中气
Keywords:
Cirrhosis Ascites Spleen Single abdominal distension Ascites treatment of the spleen Replenishing the middle qi
分类号:
R 575.2
DOI:
DOI:10.3969/j.issn.1000-7369.2024.06.019
文献标志码:
A
摘要:
腹水(单腹胀)是以单纯腹部胀大,青筋暴露,色素沉着为主要临床表现的疾病。阐明治疗单腹胀“培养、招纳、解散”三法源头及具体含义:“培养、招纳、解散”三法为清代医家喻昌治疗单腹胀时率先提出来的有效治法。“培养”即补益元气,“招纳”即升阳运脾,“解散”即疏表利小便。分析单腹胀的病因病机:其一为妄用泻脾之药,其二为病位不明,忽略脾在单腹胀治疗中的核心地位,其三为病治不宜,最终导致脾气衰微,四运不继,气血水不运胶结壅滞腹部。导师胡世平教授在继承先贤理论基础上,进一步提炼丰富“培养、招纳、解散”三法为:“培养”即腹水治脾,大补中气,“招纳”即升阳运枢,妙用风药,“解散”即蠲利水道,气血并疏。
Abstract:
Monoabdominal distension is a disease with simple abdominal distension,vein exposure and pigmentation as the main clinical manifestations.To clarify the origin and specific meaning of the three methods of “cultivation,invocation and dissolution” in the treatment of monoabdominal distension:“Cultivation,Invocation and Dissolution” are the effective treatments first proposed by Yu Chang,a doctor in the Qing dynasty,for the treatment of monoabdominal distension.“Cultivation” is to replenish the vital energy,“invocation” is to elevate the yang and transport the spleen,and “dissolution” is to loosen the surface and facilitate urination.Analysis of the aetiology of monoabdominal distension:firstly,the use of spleen-dissolving drugs; secondly,the unknown location of the disease,ignoring the central position of the spleen in the treatment of monoabdominal distention; and thirdly,the inappropriate treatment of the disease,which ultimately led to the weakening of spleen qi and the lack of succession of the four movements of qi and blood,and the lack of transportation of qi,blood and water to the abdomen,which was congested.Professor Hu Shiping in the inheritance of sage theory,further refinement and enrichment of the “cultivation,recruitment,dissolution” of the three methods:“Cultivation” that is,ascites treatment of the spleen,replenishing the middle qi,“Recruitment” that is,to raise the yang transportation centre,the wonderful use of wind medicine,“Dissolution” that is,remit the water course,qi and blood and sparing.

参考文献/References:

[1] 王红丽,李燕玲,靳小雯,等.慢性肝病慢病管理模式在肝硬化腹水患者中的应用效果[J].临床消化病杂志,2021,33(5):363-366.
[2] 邢枫,雷淑娟,蒋艳明,等.顽固性肝硬化腹水的中西医结合诊治述评[J].上海中医药杂志,2023,57(8):16-20.
[3] 汪道伟,黄辉红,李冰,等.血清PCT、CRP、IL-8和IL-10联合检测在诊断肝硬化合并腹水感染中的临床应用[J].陕西医学杂志,2019,48(3):397-400.
[4] AITHAL G P,PALANIYAPPAN N,CHINA L,et al.Guidelines on the management of ascites in cirrhosis[J].Gut,2021,70(1):9-29.
[5] BALCAR L,TONON M,SEMMLER G,et al.Risk of further decompensation/mortality in patients with cirrhosis and ascites as the first single decompensation event[J].JHEP Rep,2022,4(8):100513.
[6] HE C,YANG J,JIN Z,et al.An ALbi- and ascites-based model to predict survival for bclc stage b hepatocellular carcinoma[J].Evid Based Complement Alternat Med,2022,2022:1801230.
[7] 王磊.肝硬化腹水的中西医结合诊治[J].临床肝胆病杂志,2022,38(9):1956-1961.
[8] 萧珙.学习祖国医学单腹胀与肝硬化[J].中医杂志,1958,8(6):424-425.
[9] 倪文婷.《寓意草》治疗危急病症探析[J].江西中医药,2023,54(2):1-2,5.
[10] 惠晨阳.基于古代医案与既往病历的鼓胀病用药规律研究[D].武汉:湖北中医药大学,2022.
[11] 古松,龚秋菊,李娟,等.基于古今医案云平台探讨中药外敷治疗癌性腹水的用药规律研究[J].世界科学技术-中医药现代化,2021,23(9):3180-3187.
[12] 张健.从脾论治肝硬化腹水临证探究[J].世界中西医结合杂志,2022,17(3):609-612.
[13] 赵军,师建平,段迎喜.段迎喜“升脾”学术思想探微[J].河南中医,2020,40(3):344-347.
[14] 赵尹铭,周波.易水学派李东垣风药升阳配伍特点探析[J].天津中医药大学学报,2022,41(5):559-562.
[15] 袁红霞,曹丽霞.补脾升阳法的思想渊源及临床运用举隅[J].天津中医药大学学报,2008,27(3):220-222.
[16] 唐汉庆.李东垣升脾阳诸法运用钩玄[J].辽宁中医杂志,2010,37(10):1881-1883.
[17] 纪立金.论脾胃为枢是机体内在平衡的调衡机制[J].福建中医学院学报,2000,10(3):14-16.
[18] 刘钟阳,姜婧,张钰欣,等.易水学派医家李杲“风药”理论的渊源、含义及功用探析[J].环球中医药,2022,15(11):2150-2153.
[19] 苏晓鹏,晏军,张潞潞,等.风药在慢性乙型肝炎治疗中的作用探微[J].江苏中医药,2022,54(2):40-43.
[20] 刘媛媛,刘轶凡,赵进喜,等.从防风试论风药调神[J].中华中医药杂志,2023,38(4):1618-1621.
[21] 徐巧笑,张家增,张臻,等.从气血水理论探讨肝硬化腹水辨证思路[J].环球中医药,2023,16(5):990-993.
[22] 张燕洁,李晓玲,张莹雪,等.健脾活血利水法治疗肝硬化腹水Meta分析[J].陕西中医,2023,44(6):801-807.
[23] 杨广栋,高志远,李卫民,等.益气活血利水贴敷脐治疗肝硬化腹水疗效及对患者生存质量研究[J].陕西中医,2019,40(11):1503-1506.
[24] 茹淑瑛,张福文,李柏,等.李志中辨治肝硬化腹水经验[J].北京中医药,2018,37(12):1155-1156.
[25] 张会涛,尚丽,李秋雅,等.护肝利水汤联合特利加压素治疗肝硬化腹水临床疗效及对患者血清学指标与门静脉压力的影响[J].陕西中医,2020,41(5):593-596.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81973733)
更新日期/Last Update: 2024-06-11