顾氏外科特色的中西医结合疗法治疗肛周坏死性筋膜炎经验

Experience in Treating Perianal Necrotizing Fasciitis with GU’s Surgery of Integrated Chinese Medicine and Western Medicine

肛周坏死性筋膜炎若治疗不及时常常会引起脓毒血症、休克、多器官衰竭甚至死亡,顾氏外科将其中医病名命名为“肛疽”。总结陆金根团队运用顾氏外科特色的针对肛周坏死性筋膜炎的中西医结合诊治经验。从病机为本虚标实,亦即气阴不足为本、邪毒内蕴为标出发,确立“四结合”的中西医结合治疗方针,即手术与换药相结合,西药与中药相结合,辨证与辨病相结合,整体与局部相结合。治疗原发病的同时兼顾并发症,需要利用现代西医学的手段整体调控。

Perianal necrotizing fasciitis often leads to sepsis,shock,multiple organ failure and even death if not treated promptly. In GU ’s surgery,this disease is called “anal gangrene ” as the traditional Chinese medicine(TCM) disease name. In this paper,the experience by LU Jingen ’s team in the diagnosis and treatment of perianal necrotizing fasciitis with GU’s surgery of integrated Chinese and western medicine was summarized. Based on the disease mechanism,deficient root and excessive branch,that is,deficiency of qi and yin is the root,and evil toxin accumulating internally is the branch,“four-combination” treatment protocol of integrated Chinese and western medicine,that is,the combination of surgery and drug change,and the combination of western drugs and Chinese medicinals,the combination of syndrome differentiation and disease differentiation,the combination of the whole and the local were established. During treating the primary disease,the complications should be treated simultaneously. Besides,it is necessary to use the technology of modern western medicine to regulate the whole body.