国医大师李佃贵应用浊毒理论辨治葡萄膜炎的经验探析

Discussion on Master of Traditional Chinese Medicine LI Diangui's experience in treating uveitis with turbid toxin theory

浊毒理论由国医大师李佃贵首创提出,浊毒有广义和狭义之分,广义的浊毒泛指一切对人体有害的不洁物质,而狭义的浊毒是指由于湿浊、谷浊久蕴化热而成的可对脏腑气血造成严重损害的黏腻、秽浊之物。浊毒致病广泛,浊毒理论可用于指导各种疾病的辨证及治疗。本文概括总结了李老的浊毒理论,并在浊毒理论的指导下辨治葡萄膜炎。葡萄膜炎的病因病机主要为情志不畅,化生浊毒;脾胃损伤,浊毒内蕴;正气不足,外感浊毒;浊毒伤阴,阴虚火旺。治疗以健脾益胃、化浊解毒、凉血通脉、调畅气机为主。化浊解毒为核心治则,健脾益胃、凉血通脉与调畅气机辅助化浊解毒功效的实现,脾胃健运,则气机调畅,血脉畅通,一则可从根本上截断浊毒的生成,二则可有利于浊毒物质的排出。

The theory of turbid toxins was first put forward by LI Diangui,a great master of Tradtional Chinese Medicine.Turbid toxins can be divided into broad and narrow senses.The broad sense of turbid toxins refers to all unclean substances that are harmful to the human body,while the narrow sense of turbid toxins refers to those sticky and dirty substances that can cause serious damage to Qi and blood of the internal organs due to the heat generated by long-term accumulation of dampness and food turbidity.Turbid toxins are responsible for the pathogenesis of various diseases,and the theory of turbid toxins can be used to guide the syndrome differentiation and treatment of various diseases.This paper summarizes Master LI's theory of turbid toxin and the differentiation and treatment of uveitis under the guidance of this theory.The etiology and pathogenesis of uveitis are mainly emotional disorders which transformed into turbid toxins;Spleen and stomach injuries which lead to the accumulation of turbid toxins;Insufficient vital energy which allows the generation of exogenous turbid toxins;Injured Yin caused by turbid toxins which leads to Yin deficiency and excessive fire.The treatment mainly focuses on strengthening the spleen and replenishing the stomach,resolving turbidity and detoxification,cooling blood and dredging the meridians,and regulating the flow of Qi.The core principle of eliminating turbidity and detoxification is to strengthen the spleen and replenish the stomach,cool blood and dredge the meridians,and regulate the flow of Qi to assist the realization of removing turbidity and detoxification.Once the spleen and stomoch are in good condition,the smooth regulation of Qi and unobstructed blood vessels can be achieved,which may fundamentally cut off the generation of turbid toxins at first hand,and may facilitate the discharge of turbid toxins at second hand.