基于宗气理论辨治吉兰-巴雷综合征

Differentiation and Treatment of Guillain Barre Syndrome Based on Pectoral Qi Theory

吉兰-巴雷综合征(guillain-barrésyndrome, GBS)主要病机为湿、热、气虚、阴虚,气虚是核心病机之一。而一身之气由元气、宗气、营气、卫气共同组成,元气与宗气共同构成了脏腑之气与经络之气。宗气足则人体气血运行通畅,濡养肢体经脉,呼吸平整,肌肉筋脉活动自如。吉兰-巴雷综合征的发生发展与宗气密切相关,宗气不足则气血运行不畅,血行艰涩,瘀滞不通,形体官窍失养,致人体肌肉活动不利,废用痿软;宗气不足,宗气下陷,水谷精微无法输布于形体官窍,则肢体乏力;宗气不足则外不能纳气,内不能散布水谷精微,鼓动肺之开阖,则会出现呼吸微弱,甚则呼吸困难;宗气不足即营卫不足,外无法抵御外邪,内无法化生气血营养全身,发而为病。故本病核心病机为宗气不足,宜采用补益宗气之法,方选补中益气汤合参苓白术散加减,同时合用针灸,选穴以阳明经穴为主,若有寒热之象,亦随证加减治之。

Guillain-barr é syndrome(GBS) is mainly caused by dampness, heat, qi deficiency and yin deficiency.Qi deficiency is one of the core pathogeneses.The qi of the whole body is composed of original qi,pectoral qi,nutrient qi and defense qi.The original qi and pectoral qi together constitute the qi of viscera and meridians.If pectoral qi is sufficient, then the body′s qi and blood can run smoothly, nourish the limbs′ meridians, make the breath smooth, and the muscles and tendons move freely.The occurrence and development of GBS are closely related to pectoral qi.If pectoral qi is insufficient, the qi and blood will not run smoothly, the qi and blood will stagnate, the blood flow will be difficult, the blood stasis will be blocked, and the body will lose its nourishment, which will lead to the adverse muscle activity of the human body, and the disuse will be flaccid.If pectoral qi is insufficient, the pectoral qi of the body will be depressed, and the essence of foodstuff cannot be distributed in the whole body, then the limbs will be weak.If pectoral qi is insufficient, faiure to absorb qi outside, and distribute foodstuff essence inside and open and close lungs will appear, resulting in weak breathing, even dyspnea.Insufficient pectoral qi means deficient nutrient-defense qi,resulting in failure to prevent external pathogenics, and generate qi and blood to nourish the whole body, causing disease.Therefore, the core pathogenesis of GBS is the deficiency of pectoral qi,so the method of supplementing pectoral qi should be adopted, that′s why Center-Supplementing and Qi-Boosting Decoction combined with Modified Ginseng, Poria and White Atractylodes Powder is used.At the same time, acupuncture and moxibustion are combined to focus on points of yang brightness meridians.If there are signs of cold and heat, they can also be treated according to the exact symptoms.