1.河南中医药大学第一附属医院脑病中心,河南省郑州市金水区人民路19号,450099
2.河南中医药大学第一临床医学院
3.中西医防治重大疾病河南省协同创新中心
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收稿:2024-07-23,
修回:2024-09-10,
纸质出版:2024-12-02
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余欢,孙永康,宋研博等.运用举陷法从“虚、毒、风热”论治肌萎缩侧索硬化症[J].中医杂志,2024,65(23):2476-2481.
YU Huan,SUN Yongkang,SONG Yanbo,et al.Treatment of Amyotrophic Lateral Sclerosis by the Method of Lifting the Sunken from "Deficiency,Toxin, Wind-Heat"[J].Journal of Traditional Chinese Medicine,2024,65(23):2476-2481.
余欢,孙永康,宋研博等.运用举陷法从“虚、毒、风热”论治肌萎缩侧索硬化症[J].中医杂志,2024,65(23):2476-2481. DOI: 10.13288/j.11-2166/r.2024.23.015.
YU Huan,SUN Yongkang,SONG Yanbo,et al.Treatment of Amyotrophic Lateral Sclerosis by the Method of Lifting the Sunken from "Deficiency,Toxin, Wind-Heat"[J].Journal of Traditional Chinese Medicine,2024,65(23):2476-2481. DOI: 10.13288/j.11-2166/r.2024.23.015.
认为大气为脾肾之气与心肺阳气在胸中相合而成,充斥肌肉之间,能够维持肌肉正常形态。据此提出肌萎缩侧索硬化症的核心病机为大气虚陷,以虚为根本,毒、风热之邪为病情进展迅速的关键因素。将肌萎缩侧索硬化症发展过程分为起始发病期、日益进展期、急速加重期,运用举陷法从虚、毒、风热辨治。临证喜用风药,依据临床经验在黄芪、升麻、柴胡等风药基础上从“虚、毒、风热”角度加减自拟举陷汤系列方。起始发病期治以益气生肌举陷汤、温阳利咽举陷汤,日益进展期治以解毒举陷汤,急速加重期治以银翘疏风举陷汤、养血熄风举陷汤。
It is regarded that the general
qi
is the combination of spleen-kidney qi and heart-lung
yang qi
in the chest, which is filled between the muscles and is able to maintain the normal shape of the muscles. Accordingly, it is proposed that the core pathogenesis of amyotrophic lateral sclerosis (ALS) is the deficiency sinking of general
qi
, with "deficiency" as the root, and "toxin" and "wind-heat" as the key factors for the rapid progression of the disease. The development process of ALS was classified into the initial onset stage, the increasingly progressive stage, and the rapid exacerbation stage, and differentiated and treated by deficiency, toxin, and wind-heat. Based on clinical experience, the wind medicinals were preferred. We formed self-prescribed
Juxian Decoction
(举陷汤) and modified from the perspective of "deficiency, toxicity, wind-heat" based on the wind medicinals of Huangqi (
Radix Astragali
), Shengma (
Actaea cimicifuga L.
), Chaihu (
Bupleurum spp.
) and so on. For the initial onset stage,
Yiqi Shengji Juxian Decoction
(益气生肌举陷汤),
Wenyang Liyan Juxian Decoction
(温阳利咽举陷汤) could be used; for the increasingly progressive stage,
Jiedu Juxian Decoction
(解毒举陷汤) could be used; for the rapid exacerbation stage,
Yinqiao Shufen Juxian Decoction
(银翘疏风举陷汤),
Yangxue Xifeng Juxian Decoction
(养血熄风举陷汤) could be used.
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