门成福辨治良性前列腺增生症经验

Men Chengfu′s Experience in Differentiating and Treating Benign Prostatic Hyperplasia

良性前列腺增生症属于中医学"精癃"范畴,主要是由肾气亏虚、肺失宣降而致痰浊、瘀血等病理产物瘀结于水道所致。临证之际,应审证候虚实;分清标本缓急,活用攻补大法;重视肾脏之本;强调活血化瘀之法。中气不足、肾阳亏损、肾阴亏虚多属虚证,多责之于脾、肾。肾阳亏损证,治当温阳化气利尿,多以金匮肾气丸加减治疗;肾阴亏虚证,治当滋阴利尿,方以六味地黄丸加减治疗;中气不足证,治当益气利尿,方以补中益气汤加减治疗。肺热壅盛、气滞血瘀、湿热下注多属实证,多责之于肺、肝、膀胱。肺热壅盛证,治当宣肺泻热、通调水道,多选用枇杷开肺汤、黄芩清肺饮、加减麻杏石甘汤等治疗;气滞血瘀证,治当行气活血利尿,多选用沉香散合桂枝茯苓丸加味治疗;湿热下注证,治当清热利水,多选用八正散治疗。

Benign prostatic hyperplasia(BPH)belongs to the category of"prostatic hypertrophy"in TCM,which mainly caused by the stasis of pathological products such as Phlegm turbidity and Blood stasis in Shuidao due to deficiency of kidney Qi and lack of lung Qi dispersing.In clinical treatment,reviewing the deficiency and excess of the syndrome,distinguishing the priority of manifestation and root cause,utilization the reinforcement and elimination methods,paying attention to the foundation of the kidney as well as emphasizing the method of promoting Blood circulation for removing Blood stasis should be done.Insufficiency of splenogastric Qi,deficiency of kidney Yang,and deficiency of kidney Yin are mostly deficiency syndromes,which on account of spleen and kidneys.In treatment of Kidney Yang deficiency,method of warming Yang to dissipate Qi and diuresis and Jinkuishenqi Pills modified prescription are usually used;for Kidney Yin deficiency,nourishing Yin to diuresis should be done and modified Liuwei Dihuang Pills are often used;for splenogastric Insufficiency,benefiting Qi to diuresis method should be done and modified Buzhong Yiqi Decoction is often used.The exuberance of Lung Heat,Qi-stagnancy and blood stasis,and Damp invasion of lower energizer is mostly excess syndrome,which on account of the Lung,liver,and Bladder.For exuberance of lung heat treatment,methods of clearing lungs and purging heat,to regulate Shui Dao,and Pipa Kaifei Decoction,Huangqin Qingfei Decoction,and modified Maxingshigan Decoction are often used.For Qi-stagnancy and blood stasis,methods of promoting Qi to activate blood and diuresis and Chenxiang Powder combined with Guizhi Fuling Pills are usually used;for the Damp invasion of lower energizer,Heat and dispersing and diuresis method,like Bazheng Powder are often used.