邵慧中辨证治疗复发性口腔溃疡思路和临床观察

Thinking Analysis and Observation of Clinical Efficacy for Syndrome Differentiationand Treatment of Recurrent Oral Ulcer under Dr. SHAO Huizhong’s Supervision

辨证论治是中医诊断和治疗疾病的精髓。关于辨证,历代医家提出了各自的见解,主要有八纲辨证、脏腑辨证、卫气营血辨证、三焦辨证、六经辨证、气血津液辨证、病性(六淫)辨证、经络辨证等八种传统辨证方法。复发性口腔溃疡的发病涉及免疫、营养缺乏、感染等因素,但有时也与诊疗欠缺有关。笔者有幸师从著名中医内科专家邵慧中医师,佐诊学习五种复发性口腔溃疡的门辨证,其后15年间治疗共132例复发性口腔溃疡,取得比较满意的疗效。现将其治疗口腔溃疡临证辨治思路、遣方用药和疗效观察加以整理和分析,总结邵医师在辨证论治方面的独到经验。邵医师根据辨证分型将复发性口腔溃疡分为五个类型,此文对此五类辨证分型的辨证依据、所选方剂、主要药物和善后中成药进行了详细报道。结果显示:(1)这五类辨证分型涵盖了绝大多数复发性口腔溃疡患者的临床特点和治疗要点;(2)疗效:根据复发性口腔溃疡诊断及疗效评价试行标准,治愈率显著提高,病程明显缩短;(3)用药平均7~8味,药少力专。基于精确辨证的个体化论治是邵慧中有效治疗复发性口腔溃疡的独到之处,值得传承和发扬;对于其他疾病的中医药治疗,精确辨证施治也具有一定的借鉴意义。

Syndrome differentiation-based treatment is the essence of TCM diagnosis and treatment. Regarding TCM syndrome differentiation,the medical experts of past generations have presented their respective insights,largely including the eight principles syndrome differentiation,Zang-Fu organs syndrome differentiation,Wei-Qi-Ying-Blood syndrome differentiation,triple energizerssyndrome differentiation,six meridianssyndrome differentiation,Qi-blood-bodyfluid syndrome differentiation,and meridians and collateralssyndrome differentiation. The pathogenesis of recurrent oral ulcer involves immunity,nutritional deficiency,infection and other factors,and sometimes associates with inadequate diagnosis and treatment. The author was honored to learn five types of syndrome differentiation diagnostic methods for recurrent oral ulcer under the supervision of a Dr. Shao Huizhong,a distinguished TMC physician,and treated 132 cases of recurrent oral ulcer with satisfactory efficacy achieved. To summarize the special experience of Dr. Shao in TCM syndrome differentiation and treatment of oral recurrent ulcer,the author sorted out and analyzed Dr. Shao’s thinking ways,prescription and medications,and observed the efficacy. According to the syndrome differentiation classification,Dr. Shao divided the recurrent oral ulcer into five types. This article reported the evidence of TCM syndrome differentiation,selection of prescriptions and main medications in detail. (1)These five types ofmedications classification covered clinical characteristics and key therapeutics for the vast majority of patients with recurrent oral ulcer. (2) Indices of efficacy: According to the trial criteria for diagnosis and efficacy evaluation of recurrent oral ulcer. The cure rate was significantly improved,and the course of disease was significantly shortened. (3) On the average,7 to 8 drugswere administrated. The author concluded that personalized treatment based on precise syndrome differentiation has been Dr. SHAO Huizhong’s unique featurein the treatment of oral ulcer,which is worthy of inheriting and developing,and that such an experience also is of reference significance for TCM treatment of other diseases.