范永升教授涤痰开窍法治疗系统性红斑狼疮脑病

Professor FAN Yongsheng's Treatment of Systemic Lupus Erythematosus Encephalopathy with Eliminating Phlegm and Resuscitat

[目的]总结范永升教授运用涤痰开窍法治疗系统性红斑狼疮脑病(systemic lupus erythematosus encephalopathy,SLEE)的经验。[方法]通过阅读文献,跟师临诊,收集病案,从病因病机、治法治则探讨范永升教授运用涤痰开窍法治疗系统性红斑狼疮脑病的临证经验,对其遣方用药规律予以总结分析,并附临床医案以佐证。[结果]范永升教授认为狼疮脑病常与痰瘀互结、脑窍痹阻机制有关,临证多用化痰开窍、平肝熄风的方法,常选用涤痰汤、牵正散、天麻钩藤饮等加减进行治疗,常用的药物有石菖蒲、胆南星、钩藤、半夏、竹茹、郁金、远志等。所附病案显示狼疮脑病患者呈明显的痰湿、瘀阻、脑窍受损之神志异常等症状,范永升教授以涤痰开窍法为先,参以息风通络、通腑泄热等为治疗法则,疗效颇好。[结论]范永升教授认为系统性红斑狼疮脑病以痰浊郁闭为标,根据中医"急则治其标"的治疗原则,临床用涤痰开窍法治疗系统性红斑狼疮脑病发作,具有一定疗效,值得学习和推广。

[Objective]To summarize the experience of Professor FAN Yongsheng in treating systemic lupus erythematosus encephalopathy(SLEE).[Methods]By reading the literature,consulting the teacher,collecting the medical records and discussing Professor FAN Yongsheng’s clinical experience in the treatment of SLEE with the method of clearing phlegm and opening the orifices from the etiology,to summarize and analyze the pathogenesis and treatment principles,with the clinical medical records as evidence.[Results]Professor FAN Yongsheng thinks that SLE encephalopathy is often related to the mechanism of phlegm and blood stasis and brain obstruction,and the clinical syndrome is usually treated with the methods of resolving phlegm,opening the orifices,calming the liver and calming the wind.The common drugs are Calamus,Arisaema,Uncaria,Pinellia,Bamboo,Curcuma,High aspiration,etc.The attached medical records show that SLE encephalopathy patients have the obvious symptoms,that phlegm dampness,blood stasis,brain orifices damage and so on.Professor FAN Yongsheng takes the method of clearing phlegm and opening orifices as the first,and takes the method of stopping wind and dredging collaterals,freeing the bowels and relieving heat as the treatment principle.The curative effect is quite good.[Conclusion]Professor FAN Yongsheng thinks that the appearance of SLE encephalopathy is turbid phlegm and stasis.According to the treatment principle of"urgent treatment",the method of clearing phlegm and opening the orifices to treat the attack of SLE encephalopathy has a certain effect,which is worth learning and promoting.