何伟明运用中医序贯疗法治疗尿路感染经验

HE Weiming’s Experience with Sequential Therapy for Urinary Tract Infection

[目的]总结何伟明运用中医序贯疗法治疗尿路感染的临证经验,为临床治疗尿路感染提供借鉴。[方法]通过侍诊学习,整理、分析何师治疗尿路感染的经典医案,从治疗理念、治法、辨证经验等方面探究何师运用中医序贯疗法治疗尿路感染的临证经验,同时以一则案例佐证。[结果]何师认为肾虚、湿热、瘀阻是尿路感染发病关键,其病机特点多为本虚标实、虚实兼夹,针对此病因病机,采用益肾清利活血的治则。验案为典型的尿路感染反复发作患者,急性期以清热利湿通淋为主,辅以扶正,联合中医外治法,达快速缓解症状之效;缓解期以扶正固本为要,佐以清热利湿活血之品,配合中药穴位贴敷以增效;恢复期温阳化气、培元健体,以滋肾通关胶囊联合中药泡茶方防复发。[结论]何师辨治尿路感染以“益肾清利活血”为基本治疗原则,灵活采用中医内调外治相结合的方法,分期序贯治疗,疗效显著,值得借鉴。

[Objective] To summarize HE Weiming’s clinical experience of sequential therapy in the treatment of urinary tract infection, and provide reference for clinical treatment of urinary tract infection. [Methods] Through collating and analyzing the medical cases of urinary tract infection through consultation study, HE Weiming’s clinical experience of sequential therapy in the treatment of urinary tract infection with traditional Chinese medicine(TCM) was explored from the aspects of treatment concept, treatment method and syndrome differentiation experience and a case was used to prove it. [Results] HE Weiming believes that kidney deficiency, dampness and heat, and blood stasis are the key to the pathogenesis of urinary tract infection, and the pathogenesis is mainly characterized by deficiency in origin and excess in superficiality and deficiency-excess complication. In view of this etiology and pathogenesis, the principle of benefiting the kidney,eliminating dampness and heat and promoting blood circulation is adopted. The case was a typical patient with recurrent urinary tract infection. In the acute stage, the main treatment was clearing heat, invigorating dampness and drenching, supplemented by strengthening the body resistance, combined with external treatment of TCM, to achieve rapid relief of symptoms. In the remission stage, it was necessary to strengthen the vital Qi, with heat-clearing, moisture-relieving and blood-activating products, combined with TCM acupoint application to enhance the effect. During the recovery stage, methods of warming Yang to improve Qi and reinvigorate to strengthen the body, and Zisheng Tongguan capsule combined with TCM tea recipe was adopted to prevent recurrence. [Conclusion] HE Weiming treats urinary tract infection based on the basic treatment principle of “benefiting the kidney, eliminating dampness and heat and promoting blood circulation”, and flexibly adopts the method of internal regulation and external treatment of TCM, applies staged sequential therapy,the curative effect is remarkable, which is worthy of reference.