初探王行宽教授用药之特色
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名老中医王行宽肝心同治心系病遣方经验探讨李金洋;范金茹;叶铭泉;蒋磊;陈学娟;熊杜;王行宽【摘要】王行宽教授辨治胸痹心痛,从肝治心,善用经方—小陷胸汤、瓜萎薤白半夏汤、茯苓杏仁甘草汤等,活用古验方—生脉散、柴胡陷胸汤、补中益气汤、六味地黄丸等,创“心痛治肝”之法,拟心痛灵系列(Ⅰ、Ⅱ、Ⅲ号)方、平肝煎;辨治风眩推崇从肝论治,遣古验方—六味地黄丸、二至丸、天麻钩藤饮、滋水清肝饮、半夏白术天麻汤等,自拟验方—加味滋生青阳汤、平肝煎等等,乃王老临床辨治心系病的遣方经验.【期刊名称】《湖南中医药大学学报》【年(卷),期】2014(034)006【总页数】4页(P19-22)【关键词】王行宽;心系病;从肝治心;遣方经验【作者】李金洋;范金茹;叶铭泉;蒋磊;陈学娟;熊杜;王行宽【作者单位】湖南中医药大学研究生教育学院,湖南长沙410208;湖南中医药大学第一附属医院,湖南长沙410007;湖南中医药大学研究生教育学院,湖南长沙410208;湖南中医药大学研究生教育学院,湖南长沙410208;湖南中医药大学研究生教育学院,湖南长沙410208;湖南中医药大学研究生教育学院,湖南长沙410208;湖南中医药大学第一附属医院,湖南长沙410007【正文语种】中文【中图分类】R256.2名老中医王行宽,全国老中医药专家学术经验继承第二、三、四、五批指导老师,全国名老中医传承工作室专家,湖南中医药大学第一附属医院首届终身教授。
其医案诊断明确,理法方药俱全[1]。
观其遣方颇具特色,如,杂病治肝、活用验方等[2-3],集中体现在《王行宽临床经验集》[3]一书中。
通过整理该书收录的心系病医案处方,探讨王老辨治心系病的遣方经验。
1.1 资料来源处方资料均来自《王行宽临床经验集》,选取其中患者就诊时主要诊断为胸痹心痛(冠心病)、风眩(高血压病)、心悸(心律失常)、心痹(风湿性心脏病)、心瘅(病毒性心肌炎)、不寐(失眠)这6类疾病的病例。
王行宽教授基于“虚、郁、热”治疗复发性口腔溃疡的临证思路作者:蔺晓源王瑾茜胡国恒来源:《湖南中医药大学学报》2019年第06期〔摘要〕探析首届全国名中医王行宽教授基于“虚、郁、热”的病机特点治疗复发性口腔溃疡的临证思路:口腔溃疡责之心脾积热,治当清心泻脾,方用导赤散合泻黄散、清胃散加减。
而复发性口腔溃疡易伤阴耗气,需加用益气养阴之品。
在此基础上,王老师认为复发性口腔溃疡的辨治虽不可执一而论,然其论治终不离肝、肾两脏,治必加用疏肝利胆、滋阴补肾之法,方用丹栀逍遥散、柴芩温胆汤合六味地黄丸加减,临床疗效显著。
〔关键词〕复发性口腔溃疡;虚;郁;热;清心泻脾;疏肝利胆;滋阴补肾;王行宽〔中图分类号〕R276.8; ; ; ;〔文献标志码〕B; ; ; ;〔文章编号〕doi:10.3969/j.issn.1674-070X.2019.06.010〔Abstract〕 This paper explored and analyzed one of the 1st national famous traditional Chinese medicine doctors - Professor WANG Xingkuan's clinical thinking in treating recurrent oral ulcer (ROU) based on the pathogenesis characteristics of "deficiency, depression and heat". That is: oral ulcers attribute to the accumulated heat in the heart and spleen, so the treatment is clearing heart and draining spleen, using modified Daochi Powder with Xiehuang Powder and Qingwei Powder. But ROU can easily damage Yin and consume Qi, so it is necessary to add the product of tonifying Qi and Yin. On this basis, Professor WANG believes that the syndrome differentiation and treatment of ROU cannot be treated as the same as that of common oral ulcers, but its treatment does not depart from treating liver and kidney. The treatment must be combined with the method of soothing liver and promoting bile secretion as well as nourishing Yin and supplementing kidney, by using modified Danzhi Xiaoyao Powder, Chaiqin Wendan Decoction and Liuwei Dihuang Pills,whose clinical efficacy is remarkable.〔Keywords〕 recurrent oral ulcer; deficiency; depression; heat; clearing heart and draining spleen; soothing liver and promoting bile secretion; nourishing Yin and supplementing kidney; WANG Xingkuan王行宽教授系湖南中医药大学第一附属医院主任医师、博士研究生导师,第二、三、四、五、六批全国老中医药专家学术经验继承工作指导老师,首届全国名中医,湖南省名中医,享受国务院政府特殊津贴专家。
王行宽教授运用柴百连苏饮辨治呃逆经验作者:何涛刘建和王行宽来源:《湖南中医药大学学报》2022年第08期〔摘要〕介绍王行宽教授运用柴百连苏饮辨治呃逆的经验。
王老师认为呃逆病机分内、外两因:外因有感受寒邪、热邪之不同。
寒邪伤胃,胃气失和;热蕴胃腑,胃失濡养。
内因又分虚实辨证,虚证多由正气亏虚或虚火灼胃而生,实证多责之于肝郁气滞。
临证时,王老师多注重“杂病治肝”“多脏调燮”,认为肝失疏泄导致肝气郁滞,横逆犯胃为呃逆的重要病机,治以疏肝和胃、降气止呃,方用柴百连苏饮加减,临床多有验效。
〔关键词〕呃逆;柴百连苏饮;疏肝和胃;降气止呃;柴胡;黄连;王行宽〔中图分类号〕R256.31 〔文献标志码〕B 〔文章编号〕doi:10.3969/j.issn.1674-070X.2022.08.018Professor WANG Xingkuan's experience of treating hiccup with Chaibai Liansu DecoctionHE Tao1, LIU Jianhe2*, WANG Xingkuan2(1. Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; 2. The First Hospital ofHunan University of Chinese Medicine, Changsha, Hunan 410007, China)〔Abstract〕 This paper introduces the experience of professor WANG Xingkuan, a famous Chinese doctor of traditional Chinese medicine, in differentiating and treating hiccup with Chaibai Liansu Decoction. Mr. WANG thinks hiccup has internal and external causes. The external causes are different from cold and heat, cold evil injures the stomach, and stomach Qi loses harmony; heat accumulates in the stomach, and the stomach loses nourishment. The internal causes are divided into deficiency and excess syndrome differentiation, deficiency syndrome is mainly caused by deficiency of healty Qi or burning of the stomach with empty fire, the excess syndrome is mainly due to liver stagnation and Qi stagnation. At the time of clinical diagnosis, Mr. WANG pays attention to "treating liver in miscellaneous diseases" and "regulating multiple viscera", and believes that the important pathogenesis of hiccup is the stagnation of liver Qi caused by liver insufficiency, and transverse rebellion invade the stomach. Therefore, the method of soothing the liver and harmonizing the stomach, and declining Q to relieve hiccup must be used for treatment, and Chaibai Liansu Decoction should be added and subtracted, which is often effective in clinic.〔Keywords〕 hiccup; Chaibai Liansu Decoction; soothe the liver and harmonize the stomach; decline Qi to relieve hiccup; WANG Xingkuan呃逆以呼吸系統肌肉的不自主痉挛性收缩为主要临床表现,西医多将其归属于“膈肌痉挛”范畴,可分为功能性呃逆、器质性呃逆。
王行宽教授应用宁心定悸汤治疗心悸经验作者:王伟松刘建和袁恒佑王行宽来源:《湖南中医药大学学报》2020年第02期〔摘要〕介绍王行宽教授应用宁心定悸汤治疗心悸经验。
王教授认为心悸之病位在心,与肺、肝、胆关系密切,心之气营亏虚,肝胆失疏或胆虚气怯,痰气内停,或痰气蕴热化火扰动心神或胆腑,均可导致心悸。
针对病机,遵从“损其心者,调其营卫”“心病怔忡宜温胆”思想,创制宁心定悸汤以补益气营,化痰清热,疏肝利胆,宁心定悸,临床疗效佳。
〔关键词〕心悸;宁心定悸汤;补益气营;疏肝利胆;化痰清热;王行宽〔Abstract〕This paper introduced Professor WANG Xingkuan’s experience in treating palpitations with Ningxin Dingji Decoction. Professor WANG believes that heart palpitations are located in the heart, and closely related to the lung, liver and gallbladder. Heart Qi and nutrient Qi deficiency, loss of soothing of liver and gallbladder or insufficiency of gallbladder Qi causing timidity and internal stop of phlegm Qi or phlegm Qi accumulated heat and transformed into fire disturbing the mind or gallbladder will all lead to palpitations. According to the pathogenesis,Professor WANG followed the thought of “patients with heart damage should regulate nutrient Qi and defensive Qi” and “palpitations should warm gallbladder”, created Ningxin Dingji Decoction to replenish Qi and nutrient Qi, to resolve phlegm and clear heat, soothe the liver and gallbladder,calm heart palpitations, with good clinical efficacy.〔Keywords〕 palpitations; Ningxin Dingji Decoction; replenish Qi and nutrient Qi; soothe the liver and gallbladder; resolve phlegm and clear heat; WANG Xingkuan湖南中医药大学第一附属医院王行宽教授系首届全国名中医,主任医师,博士生导师,第二、三、四、五、六批全国老中医药专家学术经验继承工作指导老师,享受国务院政府特殊津贴专家,湖南中医药大学第一附属医院首届终身教授。
王行宽教授医案赏析王行宽教授,1939 年3 月出生, 江苏镇江人。
现为湖南中医学院第一附属医院内科教授、主任医师、博士研究生导师,湖南省名中医、湖南中医学院内科学术带头人、全国老中医药专家学术经验第二批、第三批指导老师,享受政府特殊津贴。
临证40 载,精于慢性心脑血管、胃肠之疾,屡起沉疴,名噪潇湘。
医案《, 辞源》中解释“是医生治疗疾病时辨证、立法、处方用药的连续记录”,即今之病历,古称“脉案”,“诊籍”,是中医学术的重要内容之一。
当代名中医学家干祖望教授对医案与现今的病案作了精辟的区分,认为医案是“病历再加上含英咀华、杨葩振藻的文学语言而产生的文艺作品”,是“世界上唯一的、独具风格的文章”。
因此撰写医案是中医学的基本功,也是必不可少的组成部分,正如章太炎所言“中医之成绩,医案最著”。
我国之有“医案”,可追溯至汉代司马迁之《史记·扁鹊仓公列传》所载淳于意之“诊籍”,至丹溪始有专书;迨喻嘉言方有专著—《寓意草》。
继后, 优秀医案如《金子久医案》、《醉花窗医案》、《洄溪医案》、《静香楼医案》、《临证指南医案》、《丁甘仁医案》等迭现,是后人学习效仿的宝贵资料。
而近年来侧重医案、疗效并举者并不多见,基本上将病案视同于病历的代名词,尤其是即兴而作者,更是寥若晨星。
吾师王行宽教授临诊之时,即特别注重医案的写作,将中医精髓和文学技巧融汇贯通,既文笔优美,又不哗众取宠,辨证论治思路缜密,清晰明了,每一份医案都是一篇限时的即兴佳作,且通篇贯穿自己鲜明的学术特色。
笔者有幸侍诊左右,受益匪浅。
每到门诊之日,慕名求医者无不结队而候,遍三湘内外。
吾师谙熟经典,旁猎诸家,接诊之时凝神贯注,在其询问、切脉察舌之际,文笔构思已了然在胸。
四诊甫讫,即奋笔疾书,妙语珠连。
观其谴方用药,颇似调兵谴将,得心用手;察其思维活跃、敏锐,观点清晰彰然。
医案内容衷中参西,风格迥异;辨治明确,构思巧妙。
时而引经据典,翔实华丽;时而文思咄咄,敏锐毕呈;时而言简意赅,直叩根柢。
全国名中医王行宽多脏调燮治疗功能性便秘的经验作者:王伟松袁恒佑刘建和王行宽来源:《湖南中医药大学学报》2021年第06期〔摘要〕全国名中医王行宽认为功能性便秘归属于中医学“肠痹”的范畴,其病位在大肠,与肺、肝、脾密切相关,其病机关键在肠中之“气”与“津”,肺失治节,肝失疏泄,脾胃升降失权,均可使肠中气机不畅或津液不足,致大肠传导失职,大便秘结。
王教授宣肺、疏肝、理脾并用,调脏腑之气机,并润肺、柔肝、益胃、润肠,滋脏腑之津液,创制了自拟经验方肠痹汤,验之于临床,疗效显著,体现了“多脏调燮、综合治理、杂病治肝”的学术思想。
〔关键词〕功能性便秘;肠痹;多脏调燮;综合治理;杂病治肝;一气周流;肠痹汤;王行宽〔中图分类号〕R256.35;R442 〔文献标志码〕B 〔文章编号〕doi:10.3969/j.issn.1674-070X.2021.06.013Professor Wang Xingkuan’s Experience of Multi-viscera Regulating in theTreatment of Functional ConstipationWANG Weisong1, YUAN Hengyou2, LIU Jianhe2*, WANG Xingkuan2(1. Hunan University of Chinese Medicine, Changsha, Hunan 410208, China; 2. The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China)〔Abstract〕 Professor Wang Xingkuang believes that functional constipation belongs to the category of “intestinal Bi” of traditional Chinese medicine (TCM), which is located in the large intestine and is closely related to the lung,liver and spleen. The key pathogenesis is the “Qi” and “Jin” in the intestine. Wh en lung loss treatment section, liver wood loss of catharsis, spleen and stomach not transport, can all lead to the intestinal Qi is not smooth or lack of body fluid, resulting in large intestine conduction dereliction of duty and constipation. Professor Wang used the method of dispersing lung, soothing liver, regulating spleen, regulating the Qi mechanism of viscera,moistening lung, softening liver, benefiting stomach, moistening intestines, nourishing body fluid of viscera. He created Changbi Decoction, which was proved to be effective in clinical practice. It embodies the academic thought of “regulating multiple viscera, comprehensive treatment and treating liver with miscellaneous diseases”.〔Keywords〕 functional constipation; intestinal Bi; regulating multiple viscera; comprehensive treatment; treating liver with miscellaneous diseases; one Qi circulating around; Changbi Decoction; Wang Xingkuan便秘是指排便困难或费力、排便不畅、排便次数减少、粪便干结量少的一类病症,包括功能性便秘和器质性便秘[1]。
王行宽教授用益肾疏肝化瘀汤治疗胡桃夹综合征经验总结胡桃夹综合征是一种致命性疾病,其特征是血压升高、蛋白尿、肾功能损害、溶血等症状。
该病的治疗一直是医学界的难题,然而,王行宽教授经过多年的临床实践,发现了一种有效的治疗方法——益肾疏肝化瘀汤,并且取得了显著的疗效。
在本文中,将对该经验进行总结和分享。
益肾疏肝化瘀汤是一种由多种中草药组成的中药方剂,具有滋养肾脏、舒缓肝气、化解瘀血等功效。
王行宽教授在临床治疗中发现,胡桃夹综合征的患者常伴有肾脏损害和肝气不舒的症状,因此采用益肾疏肝化瘀汤进行治疗,可以综合调理多个方面的病理情况,达到良好的疗效。
在使用益肾疏肝化瘀汤治疗胡桃夹综合征时,王行宽教授注重个体化治疗方案的制定。
他根据患者的具体病情、疾病的发展阶段以及身体的整体情况,精确地选择中草药的配伍和用量,以确保最佳的疗效。
此外,他还结合针灸、推拿等中医辅助疗法,进一步促进患者的康复。
王行宽教授的治疗过程中还注重与患者的沟通和指导。
他给患者普及胡桃夹综合征的相关知识,让患者了解疾病的原因和治疗方案,增强他们的治病信心。
同时,他还指导患者进行日常保健,包括饮食调理、适当的运动等,帮助他们改变不良的生活习惯,提高身体的免疫力和抵抗力。
通过长期观察和研究,王行宽教授发现,使用益肾疏肝化瘀汤治疗胡桃夹综合征可以达到显著的疗效。
患者在经过一段时间的治疗后,血压逐渐下降,尿蛋白减少,肾功能得到改善,溶血症状也得到了缓解。
更为重要的是,治疗后的患者整体感觉良好,精神状态得到了明显的改善。
总之,王行宽教授用益肾疏肝化瘀汤治疗胡桃夹综合征的经验总结表明,中药治疗在该疾病的疗效中具有重要作用。
该治疗方法不仅能够综合调理患者的病理情况,还能够提高患者的整体抵抗力和免疫力。
然而,由于本文没有。
综合上述内容,王行宽教授通过个体化治疗方案,精确选择中草药的配伍和用量,并结合针灸、推拿等中医辅助疗法,有效治疗胡桃夹综合征。
他注重与患者的沟通和指导,普及相关知识,增强治病信心,并指导患者进行日常保健。