阙华发运用活血化瘀通络法治疗下肢丹毒经验

Que Hua-fa′s Experience of Treating Erysipelas of Lower Limbs with the Method of Activating Blood Circulation and Removing Blood Stasis and Dredging Collaterals

阙华发教授认为,血瘀为下肢丹毒的关键致病因素,急性发作期兼有湿热,治以泻热通瘀,兼和营活血,药选生地黄、赤芍、丹参、虎杖、蒲公英等清热凉血、解毒化瘀,当归、川芎、桃仁、泽兰、牛膝等和营活血。缓解期合并水饮,热、水、瘀相互影响,治以清热利湿,活血通络,减少凉血清热药物,加用萆薢、泽兰、泽泻等利湿活血药物。恢复期,热、毒已祛,治以益气健脾,化瘀利湿,药选黄芪、党参、白术、茯苓健脾利湿,柴胡、香附理气解郁以行湿滞,泽兰、路路通、益母草活血化瘀利水。久病及肾而虚寒者,治以益气温阳、化痰活血之法,药用熟附子、桂枝、鹿角片温阳活血利水。其注重“消而勿伐”,疾病后期,适当配伍补血养血药物,寓补于消之中,祛邪而不伤正,化瘀而不伤血。

Professor Que Hua-fa believes that blood stasis is the key pathogenic factor of erysipelas of lower limbs.In the acute at-tack period,it has both dampness-heat and blood stasis.The treatment uses the method of relieving heat and dredging blood stasis,harmonizing nutrient-qi and activating blood circulation.So Shengdihuang(Radix Remanniae),Chishao(Radix Paeoniae Rubra),Danshen(Radix Salviae Miltiorrhizae),Huzhang(Rhizoma Polygoni Cuspidati),Pugongying(Herba Taraxaci),etc.are used to clear heat and cool blood,detoxify and remove blood stasis;Danggui(Radix Angelicae Sinensis),Chuanxiong(Rhizoma Chuanx-iong),Taoren(Semen Persicae),Zelan(Herba Lycopi),Niuxi(Radix Achyranthis Bidentatae),etc.are used to harmonize nutri-ent-qi and activate blood circulation.In the remission period,blood stasis is combined with water retention,and heat,water and blood stasis interact with each other.The treatment focuses on clearing heat and eliminating dampness,promoting blood circulation and dredging collaterals,reducing drugs for cooling blood and clearing heat.Bixie(Rhizoma Dioscoreae Hypoglaucae),Zelan(Her-ba Lycopi),Zexie(Rhizoma Alismatis),etc.are often added to eliminate dampness and promote blood circulation.In the recovery period,heat and toxin have been removed,and the treatment is to replenish qi and invigorate the spleen,remove blood stasis and removing dampness.So Huangqi(Radix Scutellariae),Dangshen(Radix Codonopsis),Baizhu(Rhizoma Atractylodis Macrocepha-lae),Fuling(Poria)are selected to invigorate the spleen and remove dampness;Chaihu(Radix Bupleuri)and Xiangfu(Rhizoma Cyperi)are used to regulate qi and remove depression to remove dampness stagnation;Zelan(Herba Lycopi),Lulutong(Fructus Liquidambaris)and Yimucao(Herba Leonuri)are used to activate blood circulation,remove blood stasis and promote urination.For those who have been ill for a long time and have kidney deficiency and cold,the method of supplementing qi and warming yang,resolving phlegm and activating blood circulation should be used,so prepared Fuzi(Radix Aconiti Lateralis Preparata),Guizhi(Ramulus Cinnamomi),and Lujiaopian(Cornu Cervi)are used to warm yang,activate blood circulation and promote uri-nation.Professor Que pays attention to"eliminating without attacking".In the late stage of the disease,he uses appropriate drugs for tonifying and nourishing blood.He combines tonic with elimination,which can dispel pathogens without harming healthy qi,and remove blood stasis without harming blood.