从“脑-心-肾-精室”轴探讨归黄方治疗湿热瘀滞型慢性前列腺炎

Exploring Guihuang Formula in Treatment of CP Based on‘Brain-Heart-Kidney-Essence Chamber’Axis

临床中慢性前列腺炎以湿热瘀滞证型为多,其形成是一个由湿化热进而痹阻气血运行的过程。治疗过程中既顾及湿、热、瘀等病理因素,又要清热不苦寒、燥湿不伤津、化瘀不动血等,以平为期,这也是遵用药“整体观”的具体体现,故在选方用药上较为棘手。“脑-心-肾-精室”轴理论强调整体辨证,将精室失用作为慢性前列腺炎发病的最终环节,采用脑、心、肾同调的手段,结合特色用药,达到整体与局部同治的效果,从而在缓解或治愈前列腺局部症状的同时也一定程度上改善了患者的全身症状。基于该理论拟定的归黄方即涵盖了以上理念,在治疗湿热瘀滞型慢性前列腺炎的临床实践中取得了良好的效果,现将其作用机理作如下探讨,以资临床参考。

Clinically,chronic prostatitis(CP)is dominated by the syndrome of damp-heat and blood stasis,which is a process from simply damp transforming into heat,then blocking the movement and circulation of Qi and blood.During the treatment,paying attention to the pathogenic factors of dampness,heat and blood stasis,clearing heat without bitter and cold herbs,drying dampness without damaging body fluid,promoting blood circulation to remove blood stasis without disturbing blood,in order to make the medication mild.It is also a kind of manifestation in holism,therefore it is complicated to select related herbs.‘Brain-Heart-Kidney-Essence chamber’axis highlights the overall syndrome differentiation,which regards the Essence chamber as the final link of CP in terms of pathogenesis,with the means of regulating Brain,Heart and Kidney at the same time and combined with specific medication,to achieve the effect of simultaneous treatment of the overall and the local,thus not only to relieve or cure local symptoms of CP,but also to improve the systemic symptoms to a certain degree.Guihuang Formula,prescribed based on above theories,has achieved good effects in treatment of CP related to damp-heat and blood stasis.This study discussed its action mechanism to provide references for its clinical application.