阴虚湿热证病案2例治验

阴虚湿热证,属本虚标实证,是临床较常见的证型之一。阴虚与湿热是一对矛盾,它们往往相互纠缠,形成恶性循环,如湿热稽留不去,热伤阴液,则阴虚愈甚;阴虚生内热,湿热内蕴,致湿热越重。因其病机复杂,累及多个脏腑,临证难识难辨。文章通过对慢性泄泻、口腔溃疡2个临床常见病证的治疗分析,体会到临床用药如过于清利刚燥则伤阴,而养阴过于滋腻则助湿,治疗较为棘手。对于湿热重者,笔者根据邪在上焦、中焦、下焦选择用方,常用甘露消毒丹、龙胆泻肝汤、三妙丸或香连丸等加减治疗。滋阴方药常选用如益胃汤、一贯煎、沙参麦冬汤等,旨在开拓中医诊疗阴虚湿热证的辨证思路。

Experiences in the Treatment of 2 Cases of Yin Deficiency and Damp Heat Syndrome

Yin deficiency and damp heat syndrome is the disorder of the deficiency in the primary and the excess in the secondary and it is one of the common syndromes in clinic. Yin deficiency and damp heat is a pair of contradictions and they often interacted with each other, resulting in the vicious circle. Reten- tion of damp heat damages yin and body fluid and results in aggravated yin deficiency. Yin deficiency pro- duces internal heat and the retention of damp heat leads to more serious damp heat. More zangfu organs are involved in the disease due to the complicated pathogenesis and the clinical symptoms are differentiated diffi- cultly. In the paper,2 common syndromes were analyzed, including chronic diarrhea and oral ulcer. It was found that overdose of medicines for drying the damp could injure yin ,and overdose of medicines for nouris- hing yin could worsen the damp. For the patients with excessive damp heat, the modified Danlu Xiaodu Pills, Longdan Xiegan Decoction, Sanmiao Pills or Xianglian Pills were commonly used according to the localization of the pathogens in the upper, middle or lower Energizers. The common formulas for nourishing yin were Yiwei Decoction, Yiguan Decoction, Shashen Maidong Decoction and the others, aiming to develop the approach to the syndrome differentiation of yin deficiency and damp heat in the diagnosis and treatment with traditional Chinese medicine.