Professor NIE Lifang believes that the occurrence of chronic kidney disease is closely related to the spleen and the stomach dysfunction.In clinical practice,she flexibly applies eight methods of regulating the spleen and the stomach to treat chronic kidney disease based on different main symptoms or pathological mechanisms,namely,the method of harmonizing the stomach and lowering the adverse qi to stop vomiting,the method of invigorating the spleen to remove dampness and promote diuresis,the method of invigorating the spleen to benefiting qi and raise clear yang,the method of clearing heat and dampness in the middle jiao,the method of clearing stomach fire and promoting bowel movement,the method of tonifying both qi and yin of the spleen and the kidney,the method of invigorating the spleen and tonifying the kidney to warm yang,and the method of regulating the liver and the spleen to harmonize blood.Professor NIE emphasizes that when using the eight methods to regulate the spleen and the stomach,attention should be paid to whether the focus is on treating the spleen or treating the stomach.She advocates invigorating the spleen and benefiting qi,supplemented with medicinals that promote qi circulation and digestion to achieve the effect of tonifying without stagnation.Mean-while,She pays attention to the interrelationships of generation and restriction among the zang-fu organs,and particularly emphasizes the methods of decoc-tion and administration of medication.She believes that considering all aspects of diagnosis and treatment is essential for achieving good therapeutic effects.
立足朱丹溪"六郁"理论,认为以气郁为首,火郁、血郁、食郁、痰郁、湿郁皆可致气机升降失司、气血津液运化失常,进而引发高血压.临床治疗高血压应重视理气行气,在此基础上辨治他郁,予宣散清热、活血化瘀、消食导滞、除湿化痰等治疗,郁久应注重滋阴降火、健脾益胃、补气养血等.
中国传统文化蕴藏着浓厚的时间气质,根植于传统文化沃土之上的中医学从本质说是一门时间医学.以中医学的哲学基础为切入点,认为阴阳五行是对自然时间秩序的标示,所以《黄帝内经》的核心理念是"时序",而五运六气学说就是对自然时序规律的具体表达.天人相应,人之脏腑经脉与四时五运、天序六气的时间变化同步律动,诊治疾病应充分考虑时间因素的影响,所以"气宜"是《黄帝内经》的治病要道.从这个角度分析,张仲景之方、李东垣之方和三因司天方,分别将不同层次的时间规律作为组方用药的重要依据,这些遵循《黄帝内经》核心理念制定的方剂体现了中医处方的最高境界,皆可归属于经方范畴,值得医者效法学习.
"虚气流滞"是王永炎院士提出的中医病机理论,指由于元气亏虚,气血津液等流动物质运行失常,从而导致气滞、血瘀、痰凝、经络阻滞的病理过程.钱秋海教授结合多年临床经验与"虚气流滞"理论,指出痛风的病机可分为"虚气"与"流滞"两端.元气亏虚,推动无力,为发病之本;气血津液流滞局部而运行失常,为发病之标."虚气"与"流滞"互为因果,共同推动痛风的病情发展.因此,治疗痛风以补虚通滞为基本治则可获得较好疗效,降低复发率.附验案2则.
目的:探讨慢性心力衰竭的证候分布规律.方法:运用德尔菲法制定《慢性心力衰竭症状诊断量表》,并根据该量表对769例慢性心力衰竭患者的四诊信息进行数据挖掘,通过聚类分析、因子分析探究慢性心力衰竭的证候分布规律.结果:运用德尔菲法形成的《慢性心力衰竭症状诊断量表》共包含96个症状条目.针对患者四诊信息进行的因子分析显示,慢性心力衰竭的病位涉及心、脾、肝、肾、脑,病性涉及气虚、阴虚、血瘀、痰湿、阳虚;聚类分析显示,慢性心力衰竭证型包括气虚血瘀证、气阴两虚血瘀证、阳虚水泛证、痰浊壅盛证.结论:慢性心力衰竭病机特点为本虚标实,本虚以气虚、阴虚、阳虚为主,标实以瘀血、痰浊为主,最终可致气虚与阴虚、阳虚同时存在.
