张雅丽教授运用膏方治疗慢性乙型肝炎的组方用药经验浅析

Professor ZHANG Yali’s experience in treating chronic hepatitis B with concentrated decoction

慢性乙型肝炎病机复杂、症状多变、虚实相兼,一方一药难以奏效。经临床验证,应用中药膏方治疗慢性乙型肝炎实为最佳选择。膏方又称膏滋、煎膏,具有药力大、针对性强、治疗兼证多的特点;其集治、调、养于一体之优势,是中医理、法、方、药的集中体现。黑龙江省中医药科学院南岗分院张雅丽教授从事消化疾病临床工作近40载,临证经验颇丰,在治疗病毒性肝炎有独到见解。她认为慢性乙型肝炎其中医病机为湿热疫毒熏蒸肝胆、弥漫三焦而急性起病,可以运用膏方治疗慢性乙型肝炎,取得了良好效果。其膏方总的组方原则为大方复法;治肝勿忘脾肾,尤重调补先天肾为先;辨证施治,攻补兼施,以“和”为期,平调;针对每个患者的个体差异,调理气血、阴阳、寒热、虚实,或补或攻,调畅脏腑气血及阴阳,以达气机的升降出入有常不忘兼证,随证治之。其配伍特点是寓补于治、治中寓补、补治与共。治疗时当因人制宜,用药须“补而勿滞,消而勿伐,温而勿燥,寒而勿凝”。张教授倡导天人相应理论,冬季闭藏、升发阳气予以膏方滋补肝肾、调养生息尤为适宜。文章结合案例,介绍张雅丽教授运用膏方治疗慢性乙型肝炎经验,以期为临床提供参考。

The pathogenesis of chronic viral hepatitis B is complex,the symptoms are variable,and the combination of deficiency and reality makes it difficult for one prescription and one medicine to work.After clinical verification,the application of TCM medicine concentrated decoction in the treatment of chronic viral hepatitis B is the best choice.The cream has the characteristics of strong drug power,strong pertinence and wide efficacy.Its advantage of integrating treatment,regulation and maintenance is the concentrated embodiment of TCM theory,method,formula and medicine.Professor ZHANG Yali,from Nangang Branch of Heilongjiang Traditional Chinese Medicine College,has been engaged in the clinical work of digestive diseases for nearly 40 years,with rich clinical experience and unique views on the treatment of viral hepatitis.She believes that the TCM pathogenesis of chronic hepatitis B is the acute onset of dampness-heat epidemic virus endangering the liver and gall bladder,diffuse triple-Jiao(三焦),and can be treated with concentrated decoction.She emphasizes formulating prescriptions based on individual differences among patients and is adept at using medication according to the theory of correspondence between heaven and man.The characteristic of her prescription for treating hepatitis B is that it has multiple therapeutic effects,with a focus on tonifying the spleen and kidneys,and has both nourishing and therapeutic effects.In clinical practice,it has achieved good results in treating chronic hepatitis B.Professor ZHANG advocates the theory of correspondence between heaven and man,and believes that in winter,it is particularly suitable to use concentrated decoction formulas to nourish the liver and kidneys,and regulate the growth and vitality of the body.This article combines a case study to introduce Professor ZHANG Yali’s experience in using concentrated decoction formulas to treat chronic hepatitis B,in order to provide reference for clinical practice.