从津液角度浅析钟以泽治疗慢性荨麻疹思路

An analysis of ZHONG Yize’s experience in treating chronic urticaria from body fluid

文章探析钟以泽教授治疗慢性荨麻疹的临床思路。通过回顾钟师、黄师门诊过程中留下的相关验案,结合《伤寒杂病论》经历代医家研究所留下的相关学术理论及临床发挥,并结合自身临床体会,对钟师治疗慢性荨麻疹的临床经验进行归纳整理并分析,后附验案举隅。钟师多年的临证处方中,善于结合四川盆地地区的特殊气候及环境特点,常禀张机(字仲景)“保胃气、存津液”两大理念,灵机活法,随证为辨。钟师辨证常从津液角度着手,总结出慢性荨麻疹的发生、发展、结果都可归为津液的变化;病因在津液不和;病位在津液输布之地;病机在津液阻滞。津液既是慢性荨麻疹发生的物质基础,也是慢性荨麻疹发生的表现形态。钟师治疗思路为祛湿活血散风,选用药物多依《神农本草经》《药征》等典籍记载。因时、因地、因人制宜,对慢性荨麻疹起到很好的治疗效果。所选验案中,多用黄芪、白术利水祛湿,何首乌、地黄滋阴固精;辅以当归、川芎养血活血;防风、刺蒺藜祛风散邪;处方临证加减,使全身津液代谢调畅,临床效果明显,体现了标本兼治的治疗思路和经验。钟以泽教授从津液角度治疗慢性荨麻疹,疗效良好,其经验及用药值得临床推广。

This article analyzes the clinical thinking of Professor ZHONG Yize in the treatment of chronic urticaria.By reviewing the cases of Mr.ZHONG and Mr.HUANG,combined with the relevant academic theories in the Shanghan Zabing Lun(《伤寒杂病论》),clinical follow-up and combined with the author’s experience,Mr.ZHONG’s experience in the treatment of chronic urticaria was summarized and analyzed,and the case was attached.It is found that Mr.ZHONG is good at combining the special climate and environmental characteristics of Sichuan Basin in the treatment of chronic urticaria,and follows ZHANG Ji’s two concepts of protecting stomach Qi(气)and preserving body fluid,flexibility to treatment based on syndrome differentiation.Syndrome differentiation often starts from the perspective of body fluid.It is concluded that the occurrence,development and results of chronic urticaria can be attributed to the changes of body fluid.The disease is caused by incoordination of body fluid.The disease is located in the place of distribution of body fluid.The pathogenesis lies in the block of body fluid.Body fluid is not only the material basis of chronic urticaria,but also the manifestation of chronic urticaria.The treatment ideas are eliminating dampness,invigorating blood circulation and dispelling wind.The choice of drugs is mainly based on Shennong Bencao Jing(《神农本草经》),Yaozheng(《药征》)and so on.Suit our measures to differing conditions in terms of time,locality and persons involved.It has a good therapeutic effect on chronic urticaria.In the selected test cases,Huangqi(Radix Astragali)and Baizhu(Rhizoma Atractylodis Macrocephalae)are often selected for using diuretic of hydragogue to alleviate water retention and reliminating dampness.Shouwu(Radix Polygoni Multiflori),Dihuang(Radix Rehmanniae)are used in enriching Yin and stemming essence.Danggui(Radix Angelicae Sinensis),Chuanxiong(Rhizoma Chuanxiong)are used in nourishing blood and promoting blood circulation.Fangfeng(Radix Saposhnikoviae),Cijili(Fructus Tribuli)are used in expelling wind and clearing away pathogenic factors.In clinical practice,the prescription should be added or subtracted according to the actual situation,so that the body fluid metabolism can be smooth.The clinical effect is obvious,and it embodies the treatment idea and experience in curing both the symptoms and the root causes.Professor ZHONG Yize has a good effect on chronic urticaria from the perspective of body fluid,and his experience and medication are worthy of clinical promotion.