名老中医郑学军治疗臁疮经验

Famous old doctor Zheng Xuejun′s experience in treating venous leg ulcer

臁疮是中医外科学常见疾病,病因复杂,缠绵难愈。山西省名中医郑学军主任认为脉络湿瘀,日久蕴热成毒为本病病机之关键,内治以“调血利水、化瘀通络”为大法,自拟静脉Ⅰ号方为基本方,各期随证加减(溃疡前期为湿瘀阻络证、溃疡期为湿热瘀毒证、溃疡愈合期为本虚邪恋证);外治以“祛腐生肌”为原则,采用新法炼制红升丹,自制改良生肌玉红油纱,外用于创面;中药熏洗法用于各阶段,常用燥湿解毒洗剂、溃疡洗剂熏洗生肌;重用缠缚,促进静脉回流,减轻下肢水肿。诸法内外相佐,中西结合,取效甚佳。通过分析郑学军主任对臁疮的认识及用药经验规律,总结郑老临证经验,传承学术思想,并附验案一则,以供同道参考。

Venous leg ulcer is a common disease in TCM surgery,which has complex etiology and is difficult to heal.Di-rector Zheng Xuejun,a famous traditional Chinese medicine doctor in Shanxi Province,believes that the key to the pathogenesis of this disease is the toxicity transformed by the accumulated heat from the dampness and stasis stagnated in the vessels over time.The internal treatment is“regulating blood to alleviate water retention and removing blood stasis to dredge collateral”.Self-designed Vein Prescription I is the basic formula,and the formula can be modified according to different syndromes in different stages(dampness and stasis blocking collaterals syndrome in the early stage of ulcer,accumulated dampness,heat and stasis syndrome in the stage of ulcer,and root-deficiency combined with pathogenic factors lingering on in the healing stage).The external treatment is based on the principle of“removing slough and promoting the growth of tissue regeneration”,and uses a new method to refine Hongsheng Dan.The self-made improved Shengji Yuhong oil yarn is externally used for wound surface.Traditional Chinese medicine fumigation and washing method is used in each stage and dampness-drying detoxification lotion and ulcer lotion are often used for fumigation and washing and promoting the growth of tissue regeneration.Binding therapy is used extensively to promote venous return and reduce lower limb edema.During different therapies,the assistance of the internal and external treatments and the combination of the Chinese and the western medicine have a very good effect.Through the anal-ysis of director Zheng Xuejun′s understanding of venous leg ulcer and the experience of medication rules,this paper summarizes his clinical experience and inherits academic thoughts.And a case is attached for reference.