熊继柏辨治眩晕经验

Experience of XIONG Jibai in Distinguishing and Treating Vertigo

眩晕是以头晕、眼花为主症的病证,眩晕临床渐呈多发、频发趋势,西医多以对症处理为主,其治疗效果欠佳且容易复发。熊继柏教授,国医大师,对眩晕的诊治具有丰富的经验。熊继柏教授认为临床辨治眩晕应以虚实为纲,辨治眩晕主要在于风、痰、虚3个方面,以痰浊上泛、风阳上亢、气血虚、肾精亏损四个证型为主。痰湿眩晕治以健脾祛湿,化痰熄风,方用定眩汤加减,风阳上亢证治以平肝潜阳,清火息风,方用天麻钩藤饮加减,气血虚证治以益气升阳,方用益气聪明汤加减,肾虚眩晕治宜补肾填精,可选杞菊地黄丸。总之,辨治眩晕始终要以抓主症、辨病机为核心,在病证相合前提下随证化裁,灵活加减。现列举医案4则,并通过对医案的辨证分析,总结熊继柏教授治疗眩晕的经验,为临床学者治疗眩晕提供诊疗思路。

Vertigo is a syndrome with dizziness and vertigo as the main symptoms.Vertigo tends to be multiple and frequent clinically.Western medicine mainly focuses on symptomatic treatment.Professor XIONG Jibo,a master of traditional Chinese medicine,has rich experience in the diagnosis and treatment of vertigo.Professor XIONG Jibo believes that the clinical differentiation and treatment of vertigo should be based on deficiency and excess.The differentiation and treatment of vertigo mainly lies in the three aspects of wind,phlegm,and deficiency.host.Phlegm-damp vertigo is treated by invigorating the spleen and eliminating dampness,resolving phlegm and calming the wind.The formula is modified with Dingxuan Decoction.For syndromes of hyperactivity of wind and yang,the method is to suppress the liver and subdue the yang,clear the fire and calm the wind.The prescription is modified with Tianma Gouteng Decoction.The treatment is to invigorate Qi and promote yang,and the prescription is to add and subtract Yiqi Congming Decoction.For the treatment of dizziness due to kidney deficiency,it is suitable to invigorate the kidney and replenish essence,and Qiju Dihuang Wan can be selected.In short,the differentiation and treatment of vertigo should always focus on grasping the main symptoms and distinguishing the pathogenesis,on the premise that the diseases and syndromes are consistent,tailor them according to the syndromes,and add and subtract flexibly.Here are 4 medical cases,and through the syndrome differentiation analysis of the medical cases,summarize the experience of Professor XIONG Jibai in the treatment of vertigo,and provide diagnosis and treatment ideas for clinical scholars in the treatment of vertigo.