刘健教授从脾虚湿盛论治强直性脊柱炎经验抉微

Professor LIU Jian’s Experience in Treating Ankylosing Spondylitis from Damp Abundance Due to Splenic Asthenia

[目的]总结刘健教授治疗强直性脊柱炎的临床经验。[方法]通过随师临证,记录、分析整理刘健教授治疗强直性脊柱炎的临床病案,从病因病机、用药特点等方面总结分析刘健教授的临床经验,并列举验案加以佐证。[结果]刘健教授认为脾虚湿盛是本病的重要致病因素,围绕脾虚湿盛制定了健脾利湿、温肾暖脾等治疗法则。健脾利湿常用薏苡仁、山药、茯苓、陈皮、半夏等,温肾暖脾常用桂枝、附片、杜仲、桑寄生等,同时善用大黄。验案首诊时辨为脾虚湿盛证,治以温阳通络,后因外感内伤,辨为湿热证,治以清热舒脾,收效良好,充分体现了刘健教授治疗强直性脊柱炎"圆机活法"的临床经验。[结论]刘健教授从脾虚湿盛论治强直性脊柱炎,善用大黄治疗脾虚夹实证,临床疗效良好,值得推广学习。

[Objective]To summarize the clinical experience of Professor LIU Jian in treating ankylosing spondylitis.[Methods]Through following teacher in clinical work,recording and analyzing the clinical records of Professor LIU Jian in treating ankylosing spondylitis,Professor LIU’s clinical experience in treating ankylosing spondylitis was summarized and analyzed in terms of etiology,pathogenesis,and medication characteristics,and one case was presented to support it.[Results]Professor LIU Jian believes that damp abundance due to splenic asthenia is an important pathogenic factor of the disease.Based on the treatment of damp abundance due to splenic asthenia,the therapeutic principles of invigorating the spleen and expelling dampness,warming the kidney and the spleen are formulated.Semen Coicis,Dioscoreae Rhizoma,Poria cocos,Citri Reticulatae Pericarpium,Pinelliae Rhizoma and other drugs are commonly used for invigorating the spleen and expelling dampness;Ramulus Cinnamomi,Radix Aconiti Praeparata,Eucommia ulmoides,Ramulus Loranthi are used for warming the kidney and the spleen;and Professor LIU is also good at using Rheum Palmatum.The case was differentiated as syndrome of damp abundance due to splenic asthenia,and was treated with warming Yang to dredge collaterals;later the patient suffered from external diseases and internal injuries,differentiated as damp and heat syndromes,and achieved good results after treated with clearing the heat and relaxing the spleen.It fully embodied Professor LIU Jian’s clinical experience of flexible treatment after fully understanding and analysis.[Conclusion]Professor LIU Jian treats ankylosing spondylitis from damp abundance due to splenic asthenia,and makes good use of Rheum palmatum to treat deficiency of the spleen accompanied with excess.The clinical effect is good,and it is worth promoting.