基于毒邪理论辨治干燥综合征经验

Experience in Identifying and Treating Sjögren’s Syndrome Based on the Theory of Toxins and Pathogens

摘要: 目的：总结朴勇洙教授基于毒邪理论辨治干燥综合征的临床经验。方法：通过临床跟师、记录医案及查阅文献，从理论渊源、病因病机、辨证思路、治法方药四个层面总结朴勇洙教授辨治干燥综合征的临床经验，并附医案佐证。结果：干燥综合征以各部位的干燥症状为主要临床表现，但朴勇洙教授认为津液不足只是表象，毒邪内蕴是主要的病机，毒邪内蕴影响脏腑功能，气化失司，津液不布，故见燥相。朴勇洙教授根据多年临证经验，基于毒邪理论，总结出以解毒祛邪为基本治疗原则，根据其他症状加减用药的中医综合诊疗方法，为临床辨治干燥综合征提供思路，也对临床上燥证的治疗提供参考。结论：朴勇洙教授基于毒邪理论辨治干燥综合征，强调在治疗风湿免疫疾病的过程中，当以祛邪为要，提出了“见燥尤慎补阴”的学术观点与“燥因燥用”的治疗原则，丰富了干燥综合征的临床理论与治疗方法，为临床燥证的治疗提供理论依据和经验参考。

Abstract: Objective: To summarize Professor Piao Yongzhu’s clinical treatment of Sjögren’s syndrome based on the theory of toxins and pathogens. Method: Through clinical follow-up, recording medical cases, and reviewing the literature, we summarized Professor Piao Yongzhu’s clinical treatment of Sjögren’s syndrome from four levels: theoretical origin, etiology and pathogenesis, diagnostic thinking, and therapeutic prescriptions and medicines, with supporting medical cases. Results: Sjögren’s syndrome is mainly characterized by dryness in various parts of the body, but Prof. Piao Yongzhu believes that insufficiency is only a symptom, and toxicity is the main pathogenesis. Toxicity affects the function of the internal organs, causing disrupted Qi transformation and non-distribution of body fluids, resulting in dryness. Based on years of clinical experience, Prof. Piao Yongzhu summarized the basic treatment principle of detoxification and elimination of pathogenic factors and added and subtracted according to the other symptoms, which provides ideas for the clinical diagnosis and treatment of Sjögren’s syndrome, and also provides references for the treatment of dryness in clinics. Conclusion: Professor Piao Yongzhu’s treatment of Sjögren’s syndrome is based on the theory of toxins and pathogens, emphasizing the importance of dispelling pathogenic factors in the treatment of rheumatic diseases and putting forward the academic viewpoint of “it is especially prudent to tonify the yin in the presence of dryness” and the therapeutic principle of “using dryness to counteract dryness”, which enriches the clinical theory and treatment of Sjögren’s syndrome and provides the theoretical basis and reference for the treatment of dryness symptoms.