【摘要】：目的:金實教授師從肝病泰斗鄒良才,并獲鄒云翔、曹鳴高、付宗翰、張澤生、周仲英等名醫(yī)教誨,經(jīng)驗體會,臨床研究實踐,對肝病有著深入治療心得。并且擅用古方,不拘泥,卓立創(chuàng)新。以自身對肝病的臨床經(jīng)驗及中醫(yī)內(nèi)科辨證施治,熟悉肝病的發(fā)病機制及治療原則,秉持著對中醫(yī)中藥的熱忱,以中藥藥理對肝病治療取得療效。病毒性肝炎治療,自擬龍柴方,寓于清熱解毒,疏肝健脾,配以平地木、葉下珠、板藍根、土茯苓等抗病毒來抑制病毒的蔓延發(fā)展均有良好的成效。自身免疫性肝炎肝炎的治療,采用“流氣和絡(luò)”治之,用藥輕靈,求變求新,不拘泥古法。肝硬化疾病的治療,辨病虛實,急則治標,緩則治本,虛實夾雜,則標本兼治。故此課題乃是針對金實教授治療肝病的用藥辨證思路及法則,使得肝病的治療可以有更多的選擇,金師的學術(shù)可以繼續(xù)傳承。方法:病例收集來源于江蘇省中醫(yī)院門診、南京中醫(yī)藥大學百草堂門診部、南京中醫(yī)藥大學國醫(yī)堂門診部,2009年3月至2013年12月門診病例。并從病名、病因病機、治療原則、辨證論治、用藥特點等方面探析金實教授治療肝膽病臨床經(jīng)驗。結(jié)果:病毒性肝炎總得病機是毒邪稽留,正氣不足;自身免疫性肝炎病機是肝絡(luò)郁滯,本虛標實;肝硬化病機是肝脾失調(diào),氣血陰陽不和。結(jié)論:肝膽病是現(xiàn)代臨床最常見的疾病,病多夾雜蔓延時日甚久,嚴重甚至牽動機體的免疫調(diào)節(jié),進而危及生命。目前臨床用于治療肝膽病的方式,針對不同情況的疾病發(fā)生,給予不同的的西藥,大多只有單一性,沒有辦法有效全面的治療疾病或恢復(fù)肝功能。再者,某些西藥又因存在對腎功能或其他臟器損害,胚胎畸形,白細胞下降等副作用,限制了其在臨床的應(yīng)用。金實教授透過中醫(yī)的辨證,結(jié)合西醫(yī)的診斷,中藥的藥理研究,可從整體調(diào)控入手,通過藥理作用的效果恢復(fù)肝功能正常,臨床經(jīng)驗值得推廣。
[Abstract]:Objective: professor Jin Shi was taught and experienced by famous doctors such as Zou Yunxiang, Cao Minggao, Fu Zonghan, Zhang Zesheng, Zhou Zhongying, and clinical research practice. And good at using the ancient square, not rigid, Zhuo Li innovation. With its own clinical experience of liver disease and TCM internal medicine dialectical treatment, familiar with the pathogenesis and treatment principles of liver disease, adhering to the enthusiasm of traditional Chinese medicine, Chinese medicine pharmacology to obtain curative effect on liver disease. Viral hepatitis treatment, self-made Longchaifang, living in clearing heat and detoxification, liver and spleen, with Pingdi wood, leaf beads, Radix Isatidis, Poria cocos and other antivirus to suppress the spread of the virus has good results. The treatment of autoimmune hepatitis is treated by "flowing qi and collaterals". The treatment of liver cirrhosis disease, differentiation of deficiency and solid, urgent treatment of symptoms, slow treatment of the root cause, the mix of deficiency and reality, then both symptoms and symptoms. Therefore, the subject is aimed at Professor Jin Shi's thinking and rules of medicine differentiation in the treatment of liver disease, so that the treatment of liver disease can have more choices, and the academic work of Jin Shi can continue to be passed on. Methods: the cases were collected from the outpatient department of Jiangsu Provincial traditional Chinese Medicine Hospital, the outpatient Department of Baicaotang Hospital of Nanjing University of traditional Chinese Medicine and the outpatient Department of National Medical Hall of Nanjing University of traditional Chinese Medicine, from March 2009 to December 2013. And from the name, etiology, pathogenesis, treatment principles, syndrome differentiation, drug characteristics and other aspects of Jinshi professor treatment of liver and gallbladder disease clinical experience. Results: the general pathogenesis of viral hepatitis was the stagnation of toxin and qi, the pathogenesis of autoimmune hepatitis was stagnation of liver and collaterals, and the pathogenesis of liver cirrhosis was liver and spleen disorder, qi and blood yin and yang disharmony. Conclusion: hepatobiliary disease is the most common disease in modern clinic. At present, the clinical treatment of hepatobiliary diseases, according to the occurrence of different cases of diseases, given different western medicine, most of the only single, there is no effective and comprehensive treatment of diseases or restore liver function. Moreover, some western medicine has side effects on renal function or other organs, embryo malformation, leukopenia, etc., which limits its clinical application. Professor Jin Shi, through the differentiation of TCM syndrome, the diagnosis of western medicine and the pharmacological research of Chinese medicine, can start with the whole regulation and control, and restore the normal liver function through the effect of pharmacological action. The clinical experience is worth popularizing.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：博士
【學位授予年份】：2016
【分類號】：R249;R259

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