基于髓病主于肝胆辨治神经内分泌疾病

中医之髓,包括脑髓、脊髓、骨髓、五脏之髓,髓病包括脑髓病变及脏髓病变,髓系脑病表现为意识障碍、认知障碍、精神心理障碍、神经功能障碍等症状和体征,属于全身性疾病。基于髓系脑病理论,神经内分泌疾病具有临床症状的隐匿性和不典型性、病位的发散性和聚合性、病程的慢性进展和急性加重的病机特征。奇恒互藏,髓病与脑、胆、脉相关,髓病与五脏病变亦相关,临床表现多个脏腑同病,诸虚诸实并存,不同神经内分泌疾病的病位有一定的选择性和规律性。从肝胆寒热虚实辨治神经内分泌疾病,通过高泌乳素血症、库欣综合征2个医案,阐述了顾护阳气,少火生气;转运枢机,和法用药;补通并行,镇摄为佐;尚用风药及血肉有情之品等用药特色。

Dialectical Treatment of Neuroendocrine Disease Based on Myeleterosis is Mainly in the Liver and Gallbladder

Marrow in traditional Chinese medicine includes marrow of brain,spinal cord,bone and the five internal organs.Myelopathy includes encephalopathy and visceral myelopathy.Myeloid encephalopathy is a systemic disease characterized by consciousness disorder,cognitive disorder,mental and psychological disorder,neurological dysfunction and other symptoms and signs.Based on the theory of myeloid encephalopathy,neuroendocrine diseases have the pathogenesis characteristics of occult and atypical clinical symptoms,divergent and aggregation of disease location,chronic progression and acute exacerbation of disease course.Extraordinary organ is interconnectedness,myeleterosis is related to brain,gallbladder and pulse.Myelopathy is also related to five internal organs diseases.Clinical manifestations are multiple organs diseases coexist with deficiency and excess.The location of different neuroendocrine diseases has certain selectivity and regularity.From the liver-gallbladder cold and heat,deficiency and excess to dialectical treat neuroendocrine diseases,through two medical cases of hyperprolactinemia and Cushing syndrome,this paper explains medication characteristics of protect Yang qi and mild fire supplements qi;transport pivot and harmonize medication;unity of supplementing and unstopping and cooperate with heavy settling;still use wind medicine and medicinal with affinity to flesh and blood.