从“五痹”切入探讨危急重症的中西医病机融通与组方思路

Discussion on the Treatment of Critical Illnesses Based on the Integration of Chinese and Western Medical Pathogenesis from the Perspective of "Five Paralysis"

关键词:  中西医病机融通  危急重症  五痹  开宣解郁  组方

Key words:  integration of Chinese and Western medicine pathogenesis  critical illness  five paralysis  opening and decongesting stagnation  formulae

摘要:

基于中西医协同发展中存在的传统“单一病机”分型辨证难以全面触及危急重症复合病机的现状，探究其复合病机下的治疗法则和组方用药显得十分关键和重要。广西中医药大学第一附属医院谢胜教授团队基于中医学整体、恒动、燮理调和与三因制宜的辨证观，提出通过“中西医病机融通”思维诠释危急重症的复合病机演变规律，制定“开宣解郁十法” 并进行实际临床中的组方用药。结果提示气机逆乱导致脏腑气机郁痹是危急重症的核心病机，尤其是“脏气重叠、层层相积”的“五痹”重强机制演变贯穿了临床绝大多数危急重症的病理过程，以“中西医病机融通”组方用药取得了显著疗效。故此提出危急重症的复合病机主要表现为脏腑气机郁痹即“五痹”的创新观点，而“开宣解郁十法”的组方治疗是中西医协同救治危急重症的可能突破口，值得临床推广。

Abstract:

Based on the present situation that the traditional "single pathogenesis" syndrome differentiation in the coordinated development of Chinese and Western medicine,it is difficult to fully touch the current situation of critical and severe complex pathogenesis,so it is very important to explore the treatment rules and prescription medication under the complex pathogenesis.Based on the dialectical view of the whole,constant movement,supernatural reconciliation and three-cause system of Chinese medicine,Professor Xie Sheng's team in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine proposed to interpret the evolution law of the complex pathogenesis of critical and severe diseases through the thinking of "integration of traditional Chinese and Western medicine pathogenesis",and formulate the "ten methods of opening and decongesting stagnation" and carry out the prescription medication in clinical practice.The results suggest that the core pathogenesis of critical illness is the disorder of Qi movement leading to the stagnation of Qi in internal organs.In particular,the "five paralysis" mechanism evolution of "overlapping and accumulation of zangqi" runs through the pathological process of most critical illnesses in clinic.The prescription of "integration of traditional Chinese and western medicine pathogenesis "has achieved remarkable curative effect.Therefore,it is proposed that the compound pathogenesis of critical illness is mainly manifested as the innovative viewpoint of the internal organs ("five paralysis"),and the prescription treatment of "ten methods of opening and decongesting stagnation" is a possible breakthrough in the synergistic treatment of critical illness by Chinese and Western medicine,which is worthy of clinical promotion.