金明秀对干燥综合征“干”的认识

Jin Ming-xiu′s Understanding of"Dryness"in Sjogren′s Syndrome

金明秀教授认为,口干、眼干只是干燥综合征的表象,肾阴不足,津液亏损为"干"之源;燥邪侵袭,蕴而化毒为"干"之因;痰浊、瘀血相互胶结为"干"之果;胶着顽固,缠绵难愈,变证丛生为"干"之变。金教授治疗干燥综合征以六味地黄丸为基础方辨证论治,痰浊与瘀血夹杂者加莪术、三棱以祛瘀活血,苍术、黄柏以剔痰通络;瘀血胶结心脉,壅遏不通者加丹参、麦冬以滋阴养心;津液流于关节者加桂枝、桑枝、藤类之品以舒筋通络;伴焦虑抑郁状态者加柴胡、川楝子以疏肝解郁。金教授指出,在临证时要做到"观其脉证,知犯何逆,随证治之"。

Professor Jin Ming-xiu thinks that dry mouth and dry eyes are just the exterior symptoms of Sjogren′s syndrome.The deficiency of kidney yin and the loss of body fluid are the sources of"dryness".The invasion of dryness pathogen leads to accumulation of toxin,which is the cause of"dryness".Intermingled phlegm turbidity and blood stasis are the result of"dryness".Sticking obstinately,lingering hard to heal,and many syndrome clusters are the changes of"dryness".Professor treats Sjogren′s syndrome based on Six-Ingredient Rehmannia Pill.For those with phlegm turbidity and blood stasis,Ezhu(Rhizoma Curcumae)and Sanleng(Rhizoma Sparganii)are often added to remove blood stasis and activate blood circulation,while Cangzhu(Rhizoma Atractylodis)and Huangbai(Cortex Phellodendri Chinensis)are added to remove phlegm and dredge collaterals.For blood stasis cementing the heart,Danshen(Radix Salviae Miltiorrhizae)and Maidong(Radix Ophiopogonis)are often used to nourish yin and the heart.For body fluid flowing in the joints,Guizhi(Ramulus Cinnamomi),Sangzhi(Ramulus Mori)and rattan products are often added to relaxmuscles and tendons and dredge obstruction in the channels.For anxiety and depression,Chaichu(Radix Bupleuri)and Chuanlianzi(Fructus Toosendan)are added to relieve liver depression.Professor Jin points out that in clinical practice,it is necessary to"observe the pulse and syndrome,figure out the disease causes,and treat it according to the syndrome".