阴虚湿热证病案2例治验.pdfVIP

· 186 · 世界中西医结合杂志2014年第9卷第2期 WorldJournalofIntegratedTraditionalandWesternMedicine 2014，Vo1．9，No．2 · 临证 经 验 - 阴虚湿热证病案 2例治验 王健 【摘要】 阴虚湿热证，属本虚标实证，是临床较常见的证型之一。阴虚与湿热是一对矛盾，它们 往往相互纠缠，形成恶性循环 ，如湿热稽留不去，热伤阴液，则阴虚愈甚 ；阴虚生内热 ，湿热内蕴，致湿 热越重。因其病机复杂，累及多个脏腑 ，临证难识难辨。文章通过对慢性泄泻 、口腔溃疡2个临床常 见病证的治疗分析，体会到临床用药如过于清利刚燥则伤阴，而养阴过于滋腻则助湿，治疗较为棘手。 对于湿热重者，笔者根据邪在上焦、中焦、下焦选择用方 ，常用甘露消毒丹、龙胆泻肝汤、三妙丸或香连 丸等加减治疗。滋阴方药常选用如益 胃汤、一贯煎、沙参麦冬汤等，旨在开拓中医诊疗阴虚湿热证的 辨证思路。 【关键词】 阴虚湿热证；泄泻；口腔溃疡；中医治疗 【中图分类号】R249．1；R241．3 【文献标识码】A 【文章编号】1673—6613(2014)02—0186—03 ExperiencesintheTreatmentof2CasesofYinDeficiencyandDampHeatSyndrome WANGJian (ClinicalSchoolofTraditionalChineseMedicine，ShanxiUniversityofTraditionalChineseMedicine，Taiyuan Shanxi030024) 【Abstract】 Yindeficiencyanddampheatsyndromeisthedisorderofthedeficiencyintheprimary andtheexcessinthesecondaryanditisoneofthecommonsyndromesinclinic．Yindeficiencyanddamp heatisapairofcontradictionsandtheyofteninteractedwitheachother，resultingintheviciouscircle．Reten— tionofdampheatdamagesyin andbodyfluidandresultsinaggravatedyindeficiency．Yindeficiencypro- ducesinternalheatandtheretentionofdampheatleadstomoreseriousdampheat．Morezangfuorgansare involvedinthediseaseduetothecomplicatedpathogenesisandtheclinicalsymptomsaredifferentiateddiffi— cuhly．Inthepaper，2 commonsyndromeswereanalyzed，includingchronicdiarrheaandoralulcer．Itwas foundthatoverdoseofmedicinesfordryingthedampcouldinjureyin，andoverdoseofmedicinesfornouris- hingyincouldworsenthedamp．Forthepatientswithexcessivedampheat，themodifiedDanluXiaoduPills， LongdanXieganDecoction，SanmiaoPillsorXianglianPillswerecommonlyusedaccordingtothelocalization ofthepathogensintheupper，middleorlowerEnergizers．ThecommonformulasfornourishingyinwereYiwei Decoction，YiguanDecoction，ShashenMaidongDecoctionandtheothers，aimingtodeveloptheapproachto thesyndromedifferentiationofyindeficiencyanddampheatinthediagnosisandtreatmentwitht