房定亚从燥毒分阶段论治干燥综合征经验

FANG Dingya's Experience in Staged Treatment of Sjögren's Syndrome based on Dryness Toxin Theory

总结房定亚教授从燥毒分阶段论治干燥综合征的临证经验。认为干燥综合征病因为外感燥邪、耗伤精津,先后天不足、精衰血少,核心病机为燥毒内蕴,并从“燥金气化”的角度将其分为燥毒兼火热、燥毒兼湿热、燥毒兼痰瘀三个阶段论治。具体治疗强调主以祛邪,辅以滋阴清润之品,分阶段辨证论治,其中燥毒兼火热治当润燥解毒降火,方以自拟润燥解毒汤加减;燥毒兼湿热治当养阴清热利湿,方以春泽汤加减;燥毒兼痰瘀治当通络消痰散瘀,方以自拟散瘀消痰汤加减。

This paper summarized the experience of Professor FANG Dingya in staged treatment of Sjögren's syndrome from the perspective of dryness toxin.It is believed that the cause of Sjögren's syndrome is externally-contracted dryness,consumption of essence and fluid,congenital and acquired essence deficiency,depleted essence and insufficient blood,and the core mechanism is internal accumulation of dryness toxin.The treatment can be divided into three stages,that is dryness toxin transforming into fire-heat,damp-heat and phlegm-stasis,from the perspective of dryness metal qi transformation.It is emphasized to dispel pathogen mainly,to clear and moisten with yin-nourishing medicinals in supplementation,and to treat by stages based on syndrome differentiation.For dryness toxin with fire-heat,it is suggested to moisten dryness,resolve toxins and subdue fire,with self-made Runzao Jiedu Decoction(润燥解毒汤)in modification.For dryness toxin with damp-heat,the method of nourishing yin,clearing heat and draining dampness should be used,and Chunze Decoction(春泽汤)in modification is suggested.For dryness toxin with phlegm-stasis,it is recommended to unblock collaterals,disperse phlegm and dissipate stasis,with self-made Sanyu Xiaotan Decoction(散瘀消痰汤)in modification.