王红教授应用扶正护场理论联合穿刺引流治疗复杂性肝脓肿的诊疗经验

Professor Wang Hong's experience in the treatment of complicated liver abscess by using Fuzheng-Huchang theory combine withpunctureand drainage

部分肝脓肿用抗生素和清热解毒治疗效果不佳,且液化缓慢无法穿刺引流,治疗颇为困难,临床将此类肝脓肿定义为复杂性肝脓肿。王红教授认为复杂性肝脓肿是正虚邪侵结果,抗生素和清热解毒只是治标,扶正祛邪方为治本。护场代表着外科感染正邪交争中,正气充盈,对邪气能起到约束作用,起到限制脓肿扩散的作用,促进形成局限制脓肿。同时提出了关于早期诊断复杂性肝脓肿的辅助标准之一:影像学检查肝脓肿周围无水肿带表明护场、正气不足。王红教授将复杂性肝脓肿分为“初起期、成脓期、修复期”。初起期扶正护场、促进脓肿液化,成脓期穿刺引流给邪出路,修复期促进脓肿排出、活血生肌修复坏死组织,达到快速康复的目的。

Some liver abscesses are poorly treated with antibiotics and Qingre Jiedu,and the slow liquefaction and inability to puncture and drain make treatment difficult,and these liver abscesses are defined clinically as complicated liver abscesses.Professor Wang Hong believes that complicated liver abscess is the result of Zhengxu-Xieqin,antibiotics and Qingre Jiedu are symptomatic treatments,support-ing Zhengqi and removing the toxic substances is the radical treatment.Huchang shows that in the struggle between Zhengqi and evil in surgical infection,Zhengqi is filled and can restrain the evil,so that the local abscess formed will not exacerbates the condition.Professor Wang Hong proposed that the absence of edema bands around liver abscess by imaging is a sign of insufficient Zhengqi and the inability to form a protective field,which is one of the criteria for early diagnosis of complicated liver abscess.Professor Wang Hong staged compli-cated liver abscess into"initial stage,purulent stage,and repair stage".In the initial stage,Fuzheng-Huchang and promoting the lique-faction of liver abscess should be the most important,and in the purulent stage the puncture and drainage gives the toxic substances a way out,and in the repair period to promote abscess drainage promote blood circulation and muscle regeneration to repair necrotic tissue.So as to promote rapid recovery.