刘茂才治疗登革热后继发痉证的经验

Clinical Experience of LIU Mao-Cai in the Treatment of Secondary Convulsive Syndrome After Dengue Fever

介绍全国名中医刘茂才教授诊治登革热后继发痉证的经验。刘茂才教授认为,登革热患者出现高热、腹泻等症状,经治疗后热退,但逐渐出现了项背强直、四肢抽搐、口噤、角弓反张等痉证表现,此时气阴两虚兼有痰湿、瘀血等留滞络脉,已成虚实夹杂之证,其病机之根本为阴虚风动;治疗以滋水涵木、养阴熄风为原则,在养阴熄风的基础上随证加减、灵活处方,同时不忘泻下通腑。养阴熄风临证用药可选钩藤、羚羊角、白芍、玄参、生地黄、麦冬、沙参、山茱萸肉等,通腑可用承气汤类方。

This article introduces the experience of Professor LIU Mao-Cai,a nationally renowned traditional Chinese medicine practitioner,in the treatment of secondary convulsive syndrome after dengue fever.In the view of Professor LIU Mao-Cai,patients with dengue fever usually manifested symptoms of high fever and diarrhea firstly,and then gradually presented convulsive manifestations of stiffness of neck and back,convulsion of limbs,lockjaw and opisthotonus after subsiding the fever with Chinese medicine,which indicated that both qi and yin were deficiency and the deficiency was complicated with the retention of phlegm-damp and blood stasis in the collaterals,and the syndrome of deficiency interweaved with excess has formed.The fundamental pathogenesis of the secondary convulsive syndrome after dengue fever is due to yin deficiency stirring up wind.And its therapeutic principle is to tonify kidney yin for nourishing liver yin,and nourish yin for extinguishing wind.On the basis of method of nourishing yin for extinguishing wind,modified prescriptions were adopted according to different syndromes,and therapy of unblocking bowels with drastic purgation should also be taken into account.The herbs used in clinic to nourish yin for extinguishing wind may include Uncariae Ramulus cum Uncis,Saigae Tataricae Cornu,Paeoniae Radix Alba,Scrophulariae Radix,Rehmanniae Radix,Ophiopogonis Radix,Adenophorae Radix,Corni Fructus,etc,and the associated prescriptions of Chengqi Decoction can be used to unblock bowels.