胡玲运用消托补法治疗复发性口腔溃疡经验

Professor HU Ling's Clinical Experience in The Treatment of Recurrent Oral Ulcer from The Perspective of Dispersing,Promoting and Tonifying

复发性口腔溃疡是一种以周期性反复发作为特点的口腔黏膜局限性溃疡损伤,由于其病因机制尚不完全清楚,西医缺乏有效的根源性治疗手段,故基于中医“顾护胃气”理论以及岭南湿热的气候特点,胡玲认为其基本病机与脾胃湿热密不可分,在治疗上将消、托、补三大内治法融会贯通于复发性口腔溃疡的分期论治中。并指出溃疡初起首当祛邪,以清热利湿化浊为法,中期托毒外出与收敛止血并用,后期重在清补脾胃、健运中州,拟消溃疡为基本方随证加减,提示在审查与保护胃气基础上,需将治疗具体化,改善患者全身症状,为远期预后奠定基础。文末以典型案例佐证,供同道参考借鉴。

Recurrent oral ulcer is a kind of oral mucosal localized ulcer injury characterized by periodic recurrence.Western medicine lacks effective root-based treatment because its etiology is not fully clear.According to the theory of traditional Chinese medicine"Protecting Stomach Qi"and the characteristic of humid and hot climate in Lingnan area,professor HU Ling suggests that its basic pathogenesis is inseparable from spleen-stomach dampness-heat,and integrates three internal treatments of"dispersing,promoting and tonifying"theory into the staged treatments of recurrent oral ulcers.The first stage is to clear pathogenic Qi,remove heat,dispel dampness and dissolve turbidity;the mid-term treatment is based on the excretion of toxins and purulent secretions,at the same time with astringent medicinal to stop bleeding;the last stage focuses on tonifying the spleen and stomach to transport and transform the middle energizer,based on Xiaokui decoction as the basic formula.Increase or decrease drugs according to the patients’clinical manifestations.Meanwhile,specify the therapeutic regimens and improve the patients'symptoms so as to lay a foundation for future treatments,with a precondition of examining and protecting stomach Qi.Examples presented in this paper could support the author's view,and offer some suggestions for medical peers.