连建伟教授眩晕验案三则赏析

Three Proved Cases by Professor LIAN Jianwei’s Differentiation and Treatment on Vertigo

[目的]探析连建伟教授辨证论治治疗眩晕的学术观点和临床经验,以期对临床眩晕的治疗有指导和启发作用。[方法]选择连建伟教授治疗不同证型眩晕验案3则,结合平素跟师随诊的心得体会,详加按评,从病因病机、辨证重点、用方特色等方面探索连教授治疗眩晕的特色和经验。[结果]连教授认为眩晕临床多见肝风上扰、气血亏虚、中气下陷3种证型,其辨证重点主要在于两手关脉之表现。所选3则医案,分别代表上述3种证型。肝风上扰者治以平肝息风、清火化痰、养血活血,气血亏虚者治以补益气血,中气下陷者治以补中益气,均取得满意效果。同时连教授强调,眩晕患者多虚实兼夹,实者以风、火、痰、瘀为主,虚者以气虚、血虚为多,治疗时则应全面把握眩晕的病因病机,从整体角度出发,根据患者风、火、痰、瘀、虚的轻重,从多角度入手治疗眩晕。[结论]连建伟教授辨治眩晕,突出关脉的辨证意义,并根据患者风、火、痰、瘀、虚的轻重分3型论治,临床疗效颇佳,其学术观点和临床遣方用药经验值得学习和推广。

[Objective]To explore and analyze Professor LIAN Jianwei’s academic views and clinical experience in the treatment of vertigo based on syndrome differentiation,so as to guide and enlighten the treatment of clinical vertigo.〔Method〕Professor LIAN Jianwei’s three cases of vertigo treatment are selected,Combined with the experience of regular consultation with doctors,this paper makes a detailed evaluation to explore the characteristics and experience of Professor LIAN in the treatment of vertigo from the aspects of etiology and pathogenesis,key points of syndrome differentiation,and characteristics of prescription.〔Result〕Professor LIAN thinks that vertigo is very common in clinic in liver and wind,Qi and blood deficiency,and middle Qi depression three types.The main point of syndrome differentiation lies in the manifestation of the relationship between the Guan pulse of two hands.The three selected cases represent the above three types of syndromes.People with liver wind should calm down liver wind,reduce phlegm by clearing fire,nourish blood and promote blood circulation.The deficiency of Qi and blood should supplement Qi and blood.Mid-air subsidence should be supplemented by tonifying midde-Jiao and Qi.Satisfactory results were obtained.Professor LIAN emphasizes that vertigo patients are more virtual and practical.The real ones are mainly wind,fire,phlegm and blood stasis,while the virtual ones are mostly Qi deficiency and blood deficiency.The etiology and pathogenesis of vertigo should be comprehensively grasped in treatment,and the treatment of vertigo should be carried out from multiple perspectives according to the severity of wind,fire,phlegm,blood stasis and deficiency from the overall perspective.〔Conclusion〕Professor LIAN Jianwei distinguishes the treatment of vertigo,highlightes the significance of syndrome differentiation related to the pulse,and divides the treatment into three types according to the severity of wind,fire,phlegm,blood stasis and deficiency.The clinical effect was quite good.Professor LIAN Jianwei’s academic viewpoint and clinical experience in treating vertigo are worth learning and promoting.