邱明义三法辨治干燥综合征经验

Qiu Mingyi’s experience in treating Sjogren syndrome with three methods

干燥综合征是以进行性外分泌腺损伤为特征的慢性系统性自身免疫病,发病机制尚未明确,西医以局部替代治疗和免疫治疗控制症状为主,但疗效不稳定;本病属中医“燥证”范畴,目前普遍认为其病机为阴虚津亏、津液不布,治法以滋阴生津、清热解毒为主。邱明义教授对于本病及其相关并发症的治疗有独到见解,认为化源不足为其根本病机,责之肺肾脾胃,精气耗伤为病进之机,内外诸邪为迁延之机。治疗时辨证结合辨病,以开源、节流、祛邪三法辨治:补益肺脾肾,益气养阴,存胃阴以开脏腑阴津之源;补敛结合,敛阴固精以节耗伤气阴之流;结合清热解毒,祛风通络之法,循因守证以祛脏腑经络之邪。邱教授辨治干燥综合征灵活施药,标本兼顾,圆机活法,效果颇佳。

Sjogren syndrome is a chronic systemic autoimmune disease characterized by progressive exocrine gland damage.The pathogenesis of Sjogren syndrome is not yet clear.Western medicine mainly uses local replacement therapy and immunotherapy to control symptoms,but the curative effect is unstable.It belongs to the category of “dryness syndrome”in traditional Chinese medicine.At present,it is generally believed that the pathogenesis is yin deficiency and fluid insufficiency,and the fluid is not distributed.Treatment focuses on nourishing yin and promoting fluid,clearing away heat and detoxifying.Professor Qiu Mingyi has a unique opinion on the treatment of this disease and its related complications.He believes that the root pathogenesis is insufficient transformation of the source,and the responsibility lies in the lung,kidney,spleen,and stomach.The loss of vital energy is the pathogenesis of the disease,and the internal and external pathogens are the mechanisms for its persistence.In treatment,syndrome differentiation is combined with disease differentiation,and the three methods of open source,reduce expenditure and eliminate evil are used for differentiation and treatment:it can replenish the lung,spleen,and kidney,replenish qi and yin,and store stomach yin to open up the source of yin and fluid in the zang fu organs;the combination of tonifying and astringent,astringent yin and strengthen essence to save the flow of qi and yin;combined with the method of clearing heat,detoxifying,expelling wind and unblocking collaterals,it can dispel the evil of viscera and meridians based on cause and syndrome.Professor Qiu is flexible in treating Sjogren syndrome,giving consideration to both the symptoms and the symptoms,and improving his Yin and Yang and five phases theory clinical thinking,according to the results of clinical dialectics,applying flexible methods to treat disease,and has a good effect.