肝硬化腹水中医外治法研究简况

The Research Overview of External Therapy of Traditional Chinese Medicine for Ascites Due to Cirrhosis

肝硬化腹水可属"臌胀""黄疸""胁痛""积聚"等范畴,为本虚标实,虚实错杂,治疗肝硬化腹水的中医外治法具有简便效验等特点,主要包括中药灌肠、敷脐疗法、穴位敷贴、针灸疗法等,"外治之理即内治之理,外治之药亦即内治之药,所异者法耳"。中医外治法同内治法一样,八纲辨证,遣方用药,透皮给药系统亦提供很好的理论支持。透皮吸收除具有消除药物浓度峰谷现象等优点,还可避免胃肠道刺激、肝脏"首关效应"等特点。外治法有单药,亦有复方,主要治则为攻下逐水、理气活血、温阳等。虚证常用黄芪、附子、肉桂等益气温阳之药;实证多为大黄、水蛭、莱菔子、芒硝等理气活血之药;攻逐水饮常用商路、甘遂、牵牛子等逐水药物;辛香类药物如冰片、麝香、远志、花椒、葱姜等药物,有促进药物透皮作用,根据中药引经药的属性,常被运用于外治方中。

Ascites due to cirrhosis belong to ＂Bloat jaundice Hypochondriac Pain Accumulation＂ and so on. This disease is deficient root with overdo superficial, mixture of asthenia and sthenia. External therapy of traditional Chinese medicine has the characteristics of simple and efficacy, including Chinese medicinal herb enema,umbilicus-applying therapy,acupoint application,acupuncture therapy and so on. Transdermal drug delivery system provides a good theoretical support. External therapy and treatment is the same, the differentiation of syndromes according to the eight principles, preventable and curative doctrine and medication. Percutaneous Absorption has the advantages of eliminating the eak-valley of drug concentration g, avoiding the irritation in gastrointestinal tract and first pass effect of the liver. External therapy use one kind of Chinese medicinal herb or a variety of Chinese medicinal herb. The main therapeutic principle include removing the moisture, promoting Qi activating blood, warming Yang and so on.Asthenic symptoms commonly use astragalus, monkshood, cinnamon. Excess commonly use rheum, leech, radish seed, glauber＇s salt. Removing the moisture commonly use Trade routes, euphorbia kansui, semen pharbitidis. Spicy drugs are often used in external treatment, such as Borneol, musk, polygala, pepper, onion ginger, because they can promote the drug transdermal effect.