衡先培治疗胫前黏液肿的临床经验

HENG Xian-pei's clinical experience in the treatment of pretibial myxedema

胫前黏液肿(PTM)是Graves’病的标志性表现,西医目前尚无有效治疗方法,预后较差。目前也较少有中医治疗PTM的报道。衡先培教授认为该病的发生主要是由于病理因素无法消除,在疾病演变过程中导致痰、气、瘀、热、风等病理产物,结聚于皮里膜外,流窜于下肢筋膜间,最终致PTM的发生。治疗上,衡教授提出以化痰通痹、软坚散结为主,参以凉血祛风、气血同调、心肾兼顾的治疗原则,分成痰凝成结、热瘀交错,风痰交夹、皮络痹塞,痰凝生瘀、胶成痼疾,气血不足、顽痰胶痼4个主要证型进行辨证论治,并形成了自己的系列经验方,在临床实践中取得良好的疗效。

Pretibial myxedema(PTM)is a landmark manifestation of Graves'disease.There is no effective treatment in western medicine,and the prognosis is poor.At present,there is also less of reports on the treatment of PTM with traditional Chinese medicine.Professor HENG Xian-pei believes that the occurrence of the disease is mainly due to the fact that pathological factors cannot be eliminated.In the process of disease evolution,it leads to pathological products such as phlegm,qi,blood stasis,heat and wind.It accumulates outside the dermis and flows between the fascia of the lower limbs,eventually leading to the occurrence of anterior tibial myxoma.In terms of treatment,professor HENG put forward the treatment principles of resolving phlegm and removing arthralgia,softening hardness and dispersing knot,and participating in cooling blood and expelling wind,harmonizing qi and blood,and giving consideration to heart and kidney.It can be divided into four main syndrome types:Phlegm congealing into knots,heat and blood stasis crisscross;Wind phlegm intersection clip,piluo closed;Phlegm congeals and blood stasis,becoming a chronic disease;Insuffcient qi and blood,persistent phlegm and chronic glue.He formed his series of empirical prescriptions,which had achieved good curative effect in clinical practice.