彭康中医脑病临证特点

PENG Kang’s Clinical Characteristics on Chinese Medicine Encephalopathy

对彭康教授的临床经验进行总结。彭康教授在中医脑病方面的临证特点大致归纳为:(1)头为诸阳之会,阳气清轻上升为清阳入脑,黄芪可升举清阳,使阳气透入脑部,最能发挥补足清阳的作用,故治疗时善于使用黄芪;(2)治病要诀,气血为纲:注重应用益气活血等方法来调和气血;(3)根据"久病必瘀"的理论,辨证应用活血化瘀通络法,临证时常应用川芎、丹参、当归、红花等药物活血化瘀通络;(4)怪病从痰治:常用祛痰法,常应用苍术、白术、法半夏、陈皮、胆南星等药物祛痰化湿;(5)根据"久痛入络"的观点,治疗脑病时常配伍虫类药物搜风通络止痛,全蝎的使用频率最高,并且全蝎使用免煎剂,巧用全蝎免煎剂保留其有效成分、减轻毒性;(6)惯用药对,如黄芪与党参、苍术与白术、赤芍与白芍、生地黄与熟地黄、磁石与神曲等;(7)在中药汤剂的基础上,常加用合理的中成药同服,可以互补两种剂型的缺点,实现药效的增幅。

To summarize the clinical experience of PENG Kang.Professor PENG Kang’s clinical characteristics in traditional Chinese medicine encephalopathy can be roughly summarized as follows:(1)As the head is the meeting of all Yang.Yangqi risesand enters the brain.Huangqi(astragalus)can lift clear Yang,make Yangqi into the brain and can play the role of making up clear Yang,so the treatment is good at using Huangqi(astragalus).(2)Qi and blood are important for treating disease.We attach importance to attention to the application of invigorating Qi and activating blood and other methods to harmonizing Qi and blood.(3)According to the theory oflong-term disease would cause blood stasis,the method of activating blood and resolving blood stasis should be used according to syndrome differentiation.Drugs such as Chuanxiong(ligusticum chuanxiong),Danshen(salvia miltiorrhiza),Dangui(angelica sinensis)and Honghua(safflower)are often used to activating blood and resolving blood stasis.(4)As some strange diseases can be treated from phlegm and the phlegm-resolving method is often used.Drugs such as Changzhu(asatractylodis),Baizhu(atractylodis),Banxia(pinellia),Chengpi(tangerine peel)and Dannanxing(arisaema cum bile)are often used to resolve phlegm and dampness.(5)According to the theory thatlong-term pain could involve collaterals and the insects drugs are often used.The use of scorpion has the highest frequency,and scorpion free-decocting formulacan retain the effective components and reduce the toxicity.(6)Drug pairs are often used,such as Huangqi(astragalus)and Dangshen(codonopsis),Cangzhu(asatractylodis)and Baizhu(atractylodis),Chishao(red peony root)and Baishao(white peony root),Shengdihuang(raw rehmanniarehmannia root)and Shudihuan(cooked rehmannia root),Cishi(magnet)and Shengqu(divine comedy).(7)On the basis of traditional Chinese medicine decoction,Chinese patent medicine is often used.Chinese patent medicine can complement the shortcomings of the twoforms and increase the efficacy of traditional Chinese medicine.