国医大师卢芳基于“窍道通利”拟泽窍汤治疗干燥综合征经验

Experience of master of traditional Chinese medicine LU Fang in treating Sjögren’s syndrome with Zeqiao Decoction based on the concept of “unobstructed orifices and channels”

关键词:  干燥综合征  国医大师  窍  名医经验  卢芳

Key words:  Sjögren’s syndrome  master of traditional Chinese medicine  orifices  famous doctor’s experience  LU Fang

摘要:

文章总结国医大师卢芳基于中医“窍道通利”思想治疗干燥综合征的临床经验，剖析其自拟泽窍汤的组方思路及创新性。卢芳教授认为干燥综合征的核心病机为“津亏窍闭、气血痹阻”，与窍道不通的病理表现高度契合，“窍”为人身气血津液流注要道、及脏腑失常外在体现，窍道通畅则功能正常，闭阻易致病，故提出“润、引、通”治疗3法，以恢复窍道通利及气血津液输布。用药需轻清为首，注重中焦运化功能，布润通利诸窍，根据临床反馈，去芜存精，拟泽窍汤并附验案1则，为干燥综合征的中医诊疗提供了新思路。

Abstract:

This article encapsulates the clinical acumen of Professor LU Fang，a master of traditional Chinese medicine（TCM），in treating Sjögren’s syndrome. His approach is grounded in the TCM tenet of “unobstructed orifices”. It delves into the formulation rationale and innovative aspects of his self-crafted Zeqiao Decoction. Professor LU Fang postulates that the fundamental pathogenesis of Sjögren’s syndrome lies in “body fluid deficiency，orifice blockage，and qi-blood stasis” a condition strikingly congruent with the pathological manifestations of orifice obstruction. In TCM theory，“orifices” serve as crucial conduits for the circulation of qi，blood，and body fluids，and also mirror internal visceral dysfunctions. When orifices remain unimpeded，normal physiological functions are maintained；conversely，their blockage often precipitates disease. In response，Professor LU Fang advocates a therapeutic triad of “moistening，guiding，and unblocking” to reinstate the patency of orifices and restore the proper distribution of qi，blood，and body fluids. In pharmacotherapy，preference is given to mild and gentle herbs. Equal importance is placed on enhancing the transformative function of the middle-jiao，thereby facilitating the moistening and unblocking of all orifices. Drawing on extensive clinical feedback，Professor LU Fang refined his approach and developed the Zeqiao Decoction. An illustrative case is presented，offering novel perspectives for the TCM diagnosis and treatment of Sjögren’s syndrome.