张允岭从“脾肾并重”论治肌萎缩侧索硬化症经验

ZHANG Yunling's Experience in the Treatment of Amyotrophic Lateral Sclerosis from Emphasis on both Spleen and Kidney

总结张允岭教授从“脾肾并重”论治肌萎缩侧索硬化症(ALS)的临证经验。认为ALS发病特点为“痿痉并病”,脾肾亏虚、邪气内伏为其根本病机,主张从脾肾双补论治本病,脾旺肾强则伏邪自平。常用黄芪、白术配合太子参、炒薏苡仁、豆蔻、砂仁等补中益气,升清降浊以健脾;肉苁蓉、菟丝子配合山药、山萸肉、熟地黄等扶火滋水以益肾。将健脾补肾作为核心治则贯穿治疗全程,在治病求本的同时,达到平息内风、安定伏邪的目的。

This paper summarized Professor ZHANG Yunling's experience in the treatment of amyotrophic lateral sclerosis(ALS)from emphasis on both spleen and kidney.It is considered that the characteristic of ALS manifested as overlap of atrophy-flaccidity disease and convulsive disease,and the core pathogenesis are the deficiency of spleen and kidney and the inner pathogenic qi.ZHANG advocated that ALS should be treated from tonifying both the spleen and kidney,as strong spleen and kidney led the latent pathogen at peace.Usually applied Huangqi(Astragalus mongholicus),Baizhu(Atractylodes macrocephala)combined with Taizishen(Pseudostellaria heterophylla),fried Yiyiren(Coix lacryma-jobi),Doukou(Myristica fragrans)and Sharen(Wurfbainia villosa)to tonify the middle and replenish qi,ascend lucidity and descend turbidity to invigorate the spleen;Roucongrong(Cistanche deserticola),Tusizi(Cuscuta chinensis)combined with Shanyao(Dioscorea oppositifolia),Shanzhuyu(Cornus officinalis)and prepared Dihuang(Rehmannia glutinosa)are used to support the fire and nourish the water,so as to replenish the spleen.The empirical formula re⁃garded invigorateing the spleen and replenishing the kidney as the core therapeutic principle throughout the treatment of the whole process,which aimed at extinguishing inner wind and pacifying latent pathogen when treating the root.