张卫华针药结合治疗乳头溢液经验

ZHANG Weihua’s Experience on Treating Nipple Discharge with Acupuncture and Medicine

目的总结陕西省名中医张卫华教授以针药结合诊治乳头溢液的经验及学术思想,为乳头溢液的治疗提供参考思路。方法通过临床跟诊、访谈及临床原始病历和处方搜集,总结张教授对乳头溢液的诊治思路,以及运用柴胡疏肝散加减结合针刺疗法治疗本病的经验。结果张教授重视"病症结合"的诊断模式,在临床中首先通过溢液的颜色、性质、量、黏稠度、持续时间、伴随症状等初步判断病情。在治疗方面,基于传统中医理论,注重"肝主疏泄"的指导思想,提出了"肝失疏泄、气郁痰凝"是乳头溢液的基本病机,以"疏肝解郁"为主要治疗法则,以柴胡疏肝散为基础方药,配合针刺疗法,临床效果明显。结论张教授治疗乳头溢液从肝郁痰凝出发,以疏肝解郁、化痰散瘀兼补脾肾为主要治法,理论结合实践,整体审查,辨证论治,运用柴胡疏肝散灵活加减用药,联合针刺疗法治疗乳头溢液,临床疗效满意。

Objective To summarize the experience and academic thought of Professor ZHANG Weihua,a famous Chinese Medicine professor in Shaanxi Province,who combined acupuncture and medicine to diagnose and treat nipple discharge,so as to provide a reference for the treatment of nipple discharge.Methods Through clinical follow-up,interview and collection of clinical original medical records and prescriptions,the author summarized Professor ZHANG’s thinking on diagnosis and treatment of nipple discharge as well as the experience in the treatment of this disease by adding and subtracting Chaihu Shugan Powder combined with acupuncture.Results Professor ZHANG attached great importance to the diagnosis mode of"combination of symptoms"and initially judged the condition of the disease through the color,nature,quantity,viscosity,duration and accompanying symptoms.In terms of treatment,based on the traditional Chinese medicine theory and the guiding ideology of"liver dominating soothing and dredging",it was proposed that"liver failing to soothe and dredge,Qi stagnation and phlegm coagulation"was the basic pathogenesis of nipple discharge.The main treatment principle was "soothing liver and relieving depression",and the basic prescription was Chaihu Shugan Powder,and the clinical effect was obvious with acupuncture treatment.Conclusion Professor ZHANG’s treatment of nipple discharge is based on liver stagnation and phlegm coagulation.The main treatment methods are to soothe the liver and relieve depression,dissipate phlegm and blood stasis,and replenish the spleen and kidney.The theory is combined with practice,overall review,syndrome differentiation and treatment.Chaihu Shugan Powder is used flexibly to add and subtract drugs,combined with acupuncture.The clinical effect is satisfactory.