中医序贯疗法治疗复发性口腔溃疡经验介绍
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R781.5

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广东省中医药局科研项目(20191283);深圳市龙华区科技创新专项资金项目(11501A20190613BB1C149)


Experience Introduction of Chinese Medicine Sequential Therapy for Recurrent Oral Ulcer
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    摘要:

    复发性口腔溃疡(ROU) 是常见的口腔黏膜疾病,具有迁延难愈、反复发作的特点。ROU 发病机制复杂,目前缺乏针对性治疗药物。笔者临床上采用中医序贯疗法治疗ROU,取得良好疗效,能缩短病程,减少复发。认为其发病与心、脾、肾三脏关系密切,主要证型包括心脾积热、脾胃气虚、阴虚火旺等。治疗上采用分期治疗,分发作期和间歇期。心脾积热证发作期以清热泻火为基本治法,予泻心导赤散为主方加减治疗;间歇期以养阴为主,兼以清热,拟用麦冬、淡竹叶、生甘草代茶饮。脾胃气虚发作期以厚土伏火为治法,采用补土伏火汤为主方加减治疗;间歇期以补益脾土为首要,气滞者予香砂六君子丸理气健脾,湿阻者予参苓白术丸健脾渗湿。阴虚火旺发作期以滋阴降火为治法,予三才封髓丹主方加减治疗;间歇期重滋补肾水,多运用六味地黄丸中成药调治。提出发作期予中药汤剂治疗,直至患者疼痛消失、溃疡愈合;间歇期根据患者体质,使用茶饮或口服中药丸剂治疗,缓缓图之,以防复发。强调临证必须要做到审证求因,知常达变,灵活加减应用,方能效彰。中医序贯疗法治疗ROU,体现了中医既病防变、未病先防的理念,可为ROU 的临床治疗提供新思路。

    Abstract:

    Abstract:Recurrent oral ulcer(ROU) is a common oral mucosal disease,which is difficult to be cured after delayed treatment and is often recurrent. The pathogenesis of ROU is complex,and there is a lack of targeted therapeutic agents. The authors apply Chinese medicine sequential therapy to treat ROU, and achieve a good curative effect, which can shorten the course of disease and reduce the recurrence. Its pathogenesis is closely related to the heart, spleen and kidney. The main syndromes include heat accumulation in the heart and spleen,spleen-stomach qi deficiency,and yin deficiency resulting in vigorous fire and so on. The treatment is based on different stages,namely the episode period and the intermittent period. During the episode period of heat accumulation in the heart and spleen syndrome, the basic treatment is to clear heat and purge fire, with modified Xiexin Daochi Powder as the main prescription; during the intermittent period,the main treatment is to nourish yin,assisted with clearing heat,and use Ophiopogonis Radix,Lophatheri Herba and Glycyrrhizaeare Radix et Rhizoma as tea for drinking. During the episode period of spleen-stomach qi deficiency,the treatment method is warming and supplementing the spleen and stomach to control fire,with modified Butu Fuhuo Tang as the main prescription;during the intermittent period,the main treatment is to supplement the spleen,with Xiangsha Liujunzi Pills to rectify qi and fortify the spleen for patients with qi stagnation and Shenling Baizhu Pills to fortify the spleen and drain dampness for patients with dampness obstruction. During the episode period of yin deficiency resulting in vigorous fire, the treatment method is enriching yin and subduing fire, with modified Sancai Fengsiu Pellet as the main prescription;during the intermittent period,the treatment is mainly to enrich and nourish kidney water, with Liuwei Dihuang Pills for recuperative medical care. It is suggested that during the episode period,the patients should be treated with Chinese medicine decoction until the pain disappeared and the ulcer healed; during the intermittent period, the patients are given tea or oral administration of Chinese medicine pills according to their constitution so as to prevent recurrence. It is emphasized that in order to achieve a good clinical effect,it is necessary to examine the syndrome and find out the cause,master the basic laws and know how to respond flexibly to specific situations,and flexibly modify and apply the prescriptions. Chinese medicine sequential therapy for ROU reflects the concept of controlling the development of existing disease and preventing disease before it arises,which can provide a new idea for the clinical treatment of ROU.

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缪旺冬,罗维军,王芹,谢婧,张维晴,赖铭波,陆文松,陈进升,王忠武.中医序贯疗法治疗复发性口腔溃疡经验介绍[J].新中医,2022,54(23):139-143

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  • 在线发布日期: 2022-12-11
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