基于虚实理论从“脾肾亏虚、肝郁邪阻”论治多系统萎缩

Treatment of multiple system atrophy based on deficiency and excess theory from “deficiency of spleen and kidney, stagnation of liver qi and blockage of evil qi”

基于虚实理论,结合临床实践,认为多系统萎缩病机本源为本虚标实,因虚致实,综合病机为脾肾亏虚、肝郁邪阻,基本病机为肾虚髓空、脾虚失运、肝郁失达、邪气内阻;临证治疗当遵循扶正祛邪、补虚泻实的原则,具体论治当补肾填精、培元固本,健脾益气、强肌化源,疏肝解郁、调畅气血,辨证祛邪、补虚泻实;临证选方用药可参考肉苁蓉丸、补中益气汤、柴胡疏肝散、越鞠丸、栀子豉汤等辨证加减化裁。

Based on the theory of deficiency and excess,combined with clinical practice,it was considered that the pathogenesis of multiple system atrophy was deficiency in origin and excess in superficiality,and deficiency led to excess,and the comprehensive pathogenesis was deficiency of spleen and kidney,stagnation of liver qi and blockage of evil qi.The basic pathogenesis was deficiency of the kidney,deficiency of the spleen,stagnation of the liver qi,and internal obstruction of evil qi.Clinical treatment should follow the principle of strengthening the body resistance and eliminating pathogenic factors,tonifying deficiency and purging excess.Specific treatment should be tonifying the kidney and replenishing essence,strengthening the spleen and replenishing qi,strengthening the muscle and transforming the source,soothing the liver and relieving depression,regulating qi and blood,eliminating pathogenic factors based on syndrome differentiation,tonifying deficiency and purging excess.Clinical prescription selection and medication could refer to Roucong Rong Pill,Buzhong Yiqi Decoction,Chaihu Shugan Powder,Yueju Pill,Zhizi Chi Decoction.