崔云教授治疗附睾炎临证经验

Prof. Cui Yun's clinical experience in diagnosis and treatment of epididymitis

目的介绍崔云教授治疗附睾炎的临证经验。方法通过采集与分析崔云教授治疗附睾炎的临床病例,结合历代名家相关论述,在充分认识病因病机的基础上,全面总结崔云教授诊治附睾炎临证经验,并举案例予以佐证。结果崔云教授认为附睾炎的发生多与先天禀赋不足、外感时邪、饮食不当、情志内伤、劳逸失度等因素有关,病位在外肾,与肝、脾、肾三脏关系密切,尤以脾为要。病性在急性期一般属实热或湿热证,慢性期本虚标实、虚实夹杂、寒热互见。脾虚失运、肾子失养是病理基础,肝郁、浊毒是主要致病因素,而湿热下注于肝肾、败精浊毒壅阻肾子是其病理关键,久病多伤阴致瘀。提出补虚健脾是根本、疏肝理气佐其治、清毒化浊贯始终、养阴化瘀莫放松的治疗方法,并在长期的临床实践中,取法于仙方活命饮,形成本病的有效验方,临证宜明辨虚实寒热、主次轻重,分期论治,选方用药而当有侧重,并配合外治法。崇尚"中和"思想在医学中的运用,遣方用药从"和"立法,临证用药以轻灵平淡为要,药性宜醇,意在顺应脾胃特性;苦辛配伍,寒温并用;气血同调,润燥兼施;还当谨守病机治以通精化浊兼以解毒消痈。结论崔云教授治疗附睾炎学术经验深刻独到,疗效卓著,值得临床推广与进一步研究。

Objective To introduce professor Cui Yun＇ s clinical experience in the treatment of epididymitis. Methods The clinical cases of epididymitis treated by Professor Cui Yun were collected. Prof. Cui Yun＇ s clinical experience in di- agnosis and treatment of epididymitis were comprehensively summarized on the basis of fully understanding the etiology and pathogenesis and combining the related discussion of ancient famous physicians. Some cases were discussed as evi- dence. Results Prof. Cui Yun agree that Epididymitis occurs with congenital deficiencies, exogenous evil,improper diet, and internal injuries caused by emotions. Dysfunction of the spleen in transportation and insufficiency of testicles was the precondition. Downward flow of dampness heat and internal toxin damaging epididymis are the key pathological points. Liv- er depression and turbidity toxin are the main pathogenic factors. Chronic illness impairs yin and leads to stasis. Prof. Cui puts forward that the treatment should take improving transportation by strengthening spleen as the foundation, soothing the liver and regulating qi as supplementation, clearing heat,removing dampness and transforming turbidity and detoxification as a necessary intervention over the disease process, and nourishing yin and dispersing blood stasis as treatment focus. For clinical prescription,harmonization method is considered most effective. Conclusion The thought of Prof. Cui Yun about mechanism and treatment of epididymitis is profound, and the clinical efficacy is obvious. It＇ s worth of clinical use and further research.