林毅运用“燮理阴阳,立法衡通”中医综合疗法辨治肉芽肿性乳腺炎

Experience of LIN Yi in Utilizing Traditional Chinese Medicine Comprehensive Therapy of “Coordinating Yin and Yang,Treating by Balancing and Dredging” for Treatment of Granulomatous Mastitis

总结全国名中医林毅教授运用"燮理阴阳,立法衡通"中医综合疗法辨治肉芽肿性乳腺炎的临证经验。林毅教授认为,根据肉芽肿性乳腺炎的临床表现,可将其分为肿块型、混合型、迁延型(转归型)3型;其治疗可全程采用中医内治法与外治法结合的综合疗法,遵守"内治以衡为本,外治以通为用"的原则;肿块型及混合型的内治法可方选自拟消痈溃坚汤加减,迁延型(转归型)的内治法可方选托里消毒散合参苓白术散加减,最终达到"平衡脏腑,燮理阴阳"的治疗目的;外治法以"散结提脓祛腐"为总则,创立"通、拔、刮、引、敷"五联法,针对疾病不同时期病情变化,选取不同外治法进行治疗。林毅教授采用中医内治法与外治法结合的综合疗法,多法并举,可实现创伤更小、疗程更短、外形更美、功能更好、副作用更少的治疗目标。

This paper introduces the clinical experience of professor LIN Yi,a national famous Chinese medicine expert,for the treatment of granulomatous mastitis with the traditional Chinese medicine comprehensive therapy of"coordinating yin and yang, treating by balancing and dredging". Professor LIN Yi believes that based on the clinical manifestations,granulomatous mastitis can be divided into three types,namely mass type,mixed type and lingered type(deteriorated type). Traditional Chinese medicine comprehensive therapy of internal treatment and external treatment can be used throughout the course of treatment. By following the principles of internal treatment with balancing therapy and external treatment with dredging therapy,the internal treatment of the mass type and the mixed type can be realized by using modified self-prescribed Xiaoyong Kuijian Decoction,and the internal treatment of the lingered type(deteriorated type)can be realized by the modification of Tuoli Xiaodu Powder plus Shen Ling Baizhu Powder,so as to achieve the goal of "balancing zang and fu,coordinating yin and yang". The external treatment for granulomatous mastitis should follow the principles of dissipating mass,draining pus, removing necrotic tissue. And by using the penta-therapy combined regimen of dredging, drawing out,scraping,draining,the external application can be performed through the modification according to the illness state in various stages. The application of traditional Chinese medicine comprehensive therapy of internal treatment and external treatment by Professor LIN Yi for the treatment of granulomatous mastitis can achieve the therapeutic goal of less trauma, shorter course of treatment, more beautiful appearance, better function, and less side effects.