从“络”论治带状疱疹后遗神经痛的中药选择

Selection of traditional Chinese medicine for treatment of postherpetic neuralgia by the viewpoint of collaterals

带状疱疹后遗神经痛是带状疱疹最常见的后遗症。稽留毒邪发作为带状疱疹发病因素,气血阴阳失调为其发病基础;经伤络损不复是带状疱疹后遗神经痛的病机关键;恰当选择中药是修复络损的前提,针对形成带状疱疹后遗神经痛的络损、络瘀、络虚、络阻确立了清热解毒护络方、活血化瘀通络方、益气养血修络方、虫类药物选配等,同时在临证时要随证加减,或选择相应的最佳组合方药,另外可配合通络止痛方局部溻渍通络止痛,目的是修复络损,恢复络脉功能,消除带状疱疹后遗神经痛。同时附验案一则,以供同道参考。

Postherpetic neuralgia is the most common sequela of herpes zoster.The pathogenic factors of herpes zoster are missed toxic pathogenic attack,and the deficiency of qi,blood,yin and yang is its pathogenic basis.The damage of main and collateral channels are the key to the pathogenesis of post-herpes zoster neuralgia;the proper choice of traditional Chinese medicine is the premise of repairing collateral damage.In view of collateral damage,collateral stasis,collateral deficiency and collateral obstruction which form post-herpes zoster neuralgia,the prescription of Qingre Jiedu Huluo Formula,Huoxue Huayu Tongluo Formula,Yiqi Yangxue Xiuluo Formula,insect drug selection,etc..At the same time,prescriptions should be added and subtracted,or the best combination of prescriptions should be selected according to the syndrome.In addition,Tongluo Zhitong Decoction is used for local lesion by means of hydropathic compress.To repair collateral damage,restore collateral function and eliminate post-herpes zoster neuralgia would be our objective.At the same time,a case is attached for reference.