张伯礼教授基于“病证同治”理论辨治下肢动脉硬化闭塞症经验

Professor ZHANG Boli's experience in treating lower extremities arteriosclerosis occlusive disease based on the theory of “same treatment of disease and syndrome”

关键词:  病证同治  下肢动脉硬化闭塞症  当归补血汤  四妙勇安汤  张伯礼

Key words:  same treatment of disease and syndrome  lower extremities arteriosclerosis occlusive disease  Danggui Buxue Decoction  Simiao Yong'an Decoction  ZHANG Boli

摘要:

总结张伯礼教授治疗下肢动脉硬化闭塞症(ASO)的临证经验。基于“病证同治”理论，提出“以辨病为先，以分期为主，以辨证为基”的诊疗思路。下肢ASO核心病机为气虚血瘀为本，热毒内蕴为标。治疗方法为全病程补气养血活血，选用当归补血汤；急性期清热解毒凉血，选用四妙勇安汤；稳定期温肾通络止痛，选用补肾通络药组。诊疗之际，应细心权衡轻重、详辨标本之急，处理好标本间关系，确定“治其所苦”为重要治疗策略。再通过典型病案，详细阐释诊疗思路及用药规律。

Abstract:

Summarize Professor ZHANG Boli’s clinical experience in treating lower extremities arteriosclerosis occlusive diseasｅ(ASO).Based on the theory of “same treatment of disease and syndrome”,the diagnosis and treatment approach are proposed that “distinguishing diseases first,mainly in stages,based on syndrome differentiation”. The core pathogenesis of lower extremities ASO is based on qi deficiency and blood stasis,with heat toxin accumulation as the symptoms. The treatment method is to tonify qi,nourish blood,and circulate blood throughout the entire course of the disease,choose Danggui Buxue Decoction；during the acute phase,clear heat,remove toxins,and cool blood,choose Simiao Yong’an Decoction；during the stable period,warm the kidney and unblock the meridians and alleviate pain,select the group of tonifying the kidney and unblocking the meridians. During diagnosis and treatment,it is important to carefully weigh the severity,carefully distinguish the urgency of the specimen,handle the relationship between the specimens,and determine “treating the suffering” as an important treatment strategy. Further,explain the diagnosis treatment ideas,and medication patterns in detail through typical medical records.