黄峰教授治疗肝硬化腹水经验

黄峰认为,肝硬化腹水的特点是正虚为本,邪实为标。肝郁气滞导致脾虚,脾虚无以运化则水湿停聚形成腹水,湿邪化热阻滞中焦又进一步加重肝郁脾虚,肝肾同源,久之累及于肾,最终导致肝、脾、肾受损及三焦运化失司。黄峰遵循辨病结合辨证的思想,主张从肝脾肾之本入手,辅之行气、利水、清热、活血以治标,采用温肾健脾、宣肺疏肝、清热化湿、活血化瘀通络之法,注重开上焦以通肺气、畅中焦以助运化、调下焦以利水湿的治疗原则,并结合患者症状、体征以及西医相关检查来判断疗效。

Professor Huang Feng's experience in treating ascites due to cirrhosis

Professor Huang Feng maintains that ascites due to liver cirrhosis is characterized by deficiency of vital qi as its root cause and excess of pathogen as its manifestation.Liver depression and qi stagnation lead to spleen defi ciency.If the spleen is defi cient,it may fail to transport and transform food and water,with water and dampness accumulating in organs and forming ascites.Dampness evil then transforms into heat and blocks middle jiao,which will further aggravate liver depression and spleen deficiency.As liver and kidney are of the same origin,liver depression therefore aff ects kidney over time,eventually leading to the damage in liver,spleen and kidney and the failure of sanjiao’s transportation and transformation function.Professor Huang Feng adheres to the idea of combining disease diagnosis with syndrome diff erentiation,advocating that the treatment of ascites due to liver cirrhosis starts from the root cause of liver,spleen and kidney,which is supplemented by promoting qi circulation,diuresis,clearing heat and activating blood circulation for eliminating the symptoms by adopting the methods of warming the kidney and invigorating the spleen,dispersing lung qi and dredging liver qi,clearing heat and resolving dampness,activating blood circulation and removing blood stasis to dredge collaterals,and focusing on the treatment principles of opening upper jiao to ventilate lung qi,smoothing middle jiao to facilitate transportation and transformation,regulating lower jiao to promote drainage of water and dampness.The treatment of ascites due to liver cirrhosis should be combined with patients’symptoms,signs and related examinations of western medicine to judge the effi cacy.