周德生辨治汗出异常经验

Zhou De-sheng′s Experience of Treating Sweating Based on Syndrome Differentiation

汗出异常乃阴阳失调所致,与脏腑气化失和有关。周德生教授治疗汗出异常,强调病证结合,虚实并调。原发病并发汗出异常,应结合其他症状及实验室检查鉴别原发病,以治疗原发病为根本,标本兼顾。汗出异常有虚有实,虚者多为气虚、血虚、阴虚、阳虚,实者多为湿热、痰饮、瘀血。营卫虚弱者,用桂枝汤;阴虚者,用当归六黄汤;阳气虚者,用玉屏风散;心血过耗者,用归脾汤;里热炽盛者,用白虎汤;湿热中阻者,用茵陈蒿汤;湿热流注下焦者,用龙胆泻肝汤;清阳不升者,用参苓白术散。汗出异常,还需结合汗液性状、颜色、质地、味道用药,结合汗出部位用药。周教授根据汗液性质、颜色、汗出部位不同,辨别正邪虚实进退,选择不同药物,佐以敛汗药物,扶正祛邪,畅达脏腑气机。

Abnormal sweating is caused by the imbalance of yin and yang,and is related to qi disharmony of viscera.The treatment should focus on combination of disease and syndrome,regulating deficiency and excess together.For the primary disease complicated with abnormal sweating,the treatment should be combined with other symptoms and laboratory examination to identify the primary disease,taking the treatment of the primary disease as the fundamental,and giving consideration to secondary aspects.Abnormal sweating has deficiency and excess.Deficiency syndrome is mostly due to qi deficiency,blood deficiency,yin deficiency and yang deficiency,while excess syndrome is mostly due to dampness and heat,phlegm retention and blood stasis.For nutrient-defense deficiency,Cinnamon Twig Decoction can be used.For yin deficiency,Chinese Angelica Six Yellow Decoction can be used.For yang deficiency,Jade Wind-Barrier Powder can be used.For too much consumption of heart blood,Spleen-Restoring Decoction can be used.For excessive heat in interior,White Tiger Decoction can be used.For dampness and heat stagnated in middle energizer,Virgate Wormwood Decoction can be used.For dampness-heat pouring down into lower energizer,Gentian Liver-Draining Decoction can be used.For lucid yang failing to ascend,Ginseng,Poria and White Atractylodes Powder can be used.For abnormal sweating,the medication should be combined with sweat properties,color,texture and taste,and sweating parts as well.According the different nature,color and location of sweat,Professor Zhou distinguishes the progress and retreat of deficiency and excess of healthy qi and pathogens,selects different medicinals,and combines with anhidrotic medicinals to strengthen healthy qi and remove pathogens,and dredge viscera qi movement.