WEBVTT00:00:01.200 --> 00:00:03.980咽炎的中医药特色疗法00:00:05.320 --> 00:00:07.440嗯我们第一第一点00:00:07.440 --> 00:00:10.540就是讲的是我们咽炎的中医概素00:00:11.480 --> 00:00:14.620咽炎呢我们中医上位置喉壁00:00:15.920 --> 00:00:16.600耳喉病呢00:00:16.600 --> 00:00:20.400中医耳鼻喉科咽喉炎的名词00:00:20.400 --> 00:00:23.520是指咽部红肿疼痛00:00:23.520 --> 00:00:25.580或者是干燥有异物感00:00:25.840 --> 00:00:27.660以及咽炎不适00:00:27.920 --> 00:00:29.120吞咽不利等00:00:29.120 --> 00:00:31.860为主要的临床表现的一种疾病00:00:32.559 --> 00:00:33.240合璧意思00:00:33.240 --> 00:00:35.000最早基于我们的内经00:00:35.000 --> 00:00:37.800如数问阴阳别论阴00:00:37.800 --> 00:00:40.240阴阳节谓之合璧00:00:40.240 --> 00:00:41.740其含义较广00:00:41.920 --> 00:00:45.440大底包含了具有咽喉部红肿00:00:45.440 --> 00:00:47.020疼痛为特点的00:00:47.560 --> 00:00:50.900多种的阴部急慢性炎症00:00:51.360 --> 00:00:56.040后世后世医家对疾病的分类嗯00:00:56.040 --> 00:00:57.640逐渐的比较详细了00:00:57.640 --> 00:00:58.640将合并一次呢00:00:58.640 --> 00:01:01.820作为一个独立的疾病把区分开来00:01:03.440 --> 00:01:06.200如侯科心法方红种00:01:06.200 --> 00:01:07.460无形为币00:01:07.600 --> 00:01:08.980有形为额00:01:09.080 --> 00:01:10.080但总的来说00:01:10.080 --> 00:01:11.120古代艺伎中00:01:11.120 --> 00:01:14.260侯币的概念一直较为笼统00:01:14.840 --> 00:01:16.260嗯现代中医00:01:16.440 --> 00:01:17.240呃00:01:17.360 --> 00:01:19.460喉科对喉壁的概念呢00:01:19.480 --> 00:01:21.880目前已经逐一的统一啊00:01:21.880 --> 00:01:24.500系专指急慢性咽炎00:01:24.840 --> 00:01:27.980根据病因的基病机不同00:01:28.200 --> 00:01:30.600急性咽炎又称风热合壁00:01:30.600 --> 00:01:32.060或者是风寒合壁00:01:36.440 --> 00:01:38.640中医的病因病机呢00:01:38.640 --> 00:01:41.980是本病的形成多因起居不慎00:01:42.400 --> 00:01:45.180肺胃湿故滞热00:01:45.760 --> 00:01:49.720滞风热邪啊毒层虚侵犯00:01:49.720 --> 00:01:51.740由口鼻而入00:01:53.120 --> 00:01:54.740侵袭我们的咽喉00:01:54.800 --> 00:01:57.100以致咽部红肿疼痛00:01:57.240 --> 00:01:59.140而发为风热合璧00:01:59.760 --> 00:02:03.580或嗯或者是阴湿湿滞物滞00:02:04.040 --> 00:02:07.300或者是平素的肺胃积热00:02:07.640 --> 00:02:10.360则邪寒邪热常理00:02:10.360 --> 00:02:13.380而出现肺热热盛的重症00:02:14.000 --> 00:02:15.460素体寒者00:02:15.520 --> 00:02:19.060风寒之邪犯于毛皮00:02:19.160 --> 00:02:20.340利阴于肺00:02:20.720 --> 00:02:21.960清结于咽喉00:02:21.960 --> 00:02:24.060则表现为风寒的喉痹00:02:25.720 --> 00:02:29.180那呢喉壁的我们的辨证治疗呢00:02:29.880 --> 00:02:32.280中医上面我们那个喉壁的症分00:02:32.280 --> 00:02:36.380辨证治疗风热外侵正合适00:02:36.920 --> 00:02:39.840正合适喉阴微肿痛00:02:39.840 --> 00:02:42.920干燥灼热感微痛00:02:42.920 --> 00:02:44.640或者是咽痒吞00:02:44.640 --> 00:02:47.800咽不利或伴有发热微寒00:02:47.800 --> 00:02:53.020恶头痛咳嗽咳痰痰黄舌00:02:53.120 --> 00:02:55.380舌质正常或者有点烧红00:02:56.200 --> 00:02:58.860舌苔薄白或者是薄黄00:02:59.200 --> 00:03:00.580脉浮素00:03:01.320 --> 00:03:03.260制则疏风解热00:03:03.880 --> 00:03:05.060解毒利阴00:03:05.240 --> 00:03:08.180我们主要的汤方是疏风解毒汤00:03:11.720 --> 00:03:14.660花样呢有进阶防风00:03:14.680 --> 00:03:15.320牛郎子00:03:15.320 --> 00:03:21.460甘草银花灵翘黄黄芩山白皮赤芍00:03:21.640 --> 00:03:22.440桔梗00:03:25.840 --> 00:03:28.880呃贝母天花粉玄参等00:03:28.880 --> 00:03:30.280头痛者可加00:03:30.280 --> 00:03:32.380可加一些我们的曼琴子00:03:32.720 --> 00:03:34.320嗯喉咽做咳呢00:03:34.320 --> 00:03:38.660可以去可以加去玄参加禅衣00:03:39.920 --> 00:03:40.860啊橘红00:03:41.000 --> 00:03:42.800若因疼痛角度呢00:03:42.800 --> 00:03:46.420可以加麝根山头根山豆根等00:03:48.560 --> 00:03:50.820风寒西肺正合适00:03:50.920 --> 00:03:52.580咽部微痛或痒00:03:53.240 --> 00:03:54.980黏膜淡红不肿00:03:55.000 --> 00:03:56.220通咽不慎00:03:56.680 --> 00:03:58.600伴恶寒微热00:03:58.600 --> 00:03:59.400无汗00:04:00.080 --> 00:04:01.260流清鼻涕00:04:01.760 --> 00:04:03.620咳嗽呢是痰清稀00:04:04.040 --> 00:04:06.400舌质也有淡红色胎盘00:04:06.400 --> 00:04:09.980嗯舌苔是薄嗯薄而白00:04:11.400 --> 00:04:12.940呃麦麸锦00:04:13.080 --> 00:04:15.040那治疗方案是辛00:04:15.040 --> 00:04:15.840嗯00:04:16.080 --> 00:04:17.120辛温解表00:04:17.120 --> 00:04:18.460疏风散寒00:04:19.840 --> 00:04:22.100主要是汤方是六味汤00:04:23.640 --> 00:04:24.560嗯方药呢00:04:24.560 --> 00:04:27.080是进阶防风00:04:27.080 --> 00:04:28.000桔梗甘草00:04:28.000 --> 00:04:31.160薄荷姜蝉苏叶00:04:31.160 --> 00:04:32.720生姜嗯00:04:32.720 --> 00:04:34.000鼻塞流涕疹呢00:04:34.000 --> 00:04:36.780可以加苍耳苍耳子00:04:36.880 --> 00:04:40.200呃心心悸咳嗽呢00:04:40.200 --> 00:04:41.900可以加直咽杏仁00:04:42.240 --> 00:04:44.600嗯有咳嗽呃喉呃00:04:44.600 --> 00:04:48.240咽部有有呃有阴阳的呢00:04:48.240 --> 00:04:50.260可以加我们的肠衣和橘红00:04:53.360 --> 00:04:53.920嗯00:04:53.920 --> 00:04:55.740肺热呃00:04:56.120 --> 00:04:58.280肺胃热盛者的患者呢00:04:58.280 --> 00:05:00.540他正喉呢是嗯00:05:00.640 --> 00:05:03.200咽咽部的红肿疼痛00:05:03.200 --> 00:05:07.240比较比较比较比较严重一点啊00:05:07.240 --> 00:05:11.700软腭及循循垂有红肿00:05:11.800 --> 00:05:14.360通咽呢有困难的痰多00:05:14.360 --> 00:05:16.100而而且比较黄00:05:16.320 --> 00:05:17.460不易咳出00:05:18.560 --> 00:05:19.540颌下呢00:05:19.920 --> 00:05:21.160有结核00:05:21.160 --> 00:05:22.800有牙痛发热00:05:22.800 --> 00:05:24.540口干头痛00:05:24.800 --> 00:05:26.240大便呢比较干结00:05:26.240 --> 00:05:27.740小便黄色00:05:27.920 --> 00:05:29.380呃舌表红00:05:29.640 --> 00:05:31.480苔黄腻脉00:05:31.480 --> 00:05:32.980呃脉红素00:05:33.680 --> 00:05:34.920嗯治疗方案呢00:05:34.920 --> 00:05:36.660是泄洪解毒00:05:36.720 --> 00:05:38.060利咽消肿00:05:38.880 --> 00:05:41.540主要的汤方是清热利葛汤00:05:42.880 --> 00:05:44.720方药主要是连翘00:05:44.720 --> 00:05:49.100银花大黄黄橙橘子薄荷牛拉子芥00:05:49.280 --> 00:05:52.320嗯进阶防风玄明粉以及玄00:05:52.320 --> 00:05:53.120参00:05:53.480 --> 00:05:55.160大病大病00:05:55.160 --> 00:05:58.300比较干燥的或者便秘的患者00:05:58.760 --> 00:06:01.180可以适量的加大黄00:06:01.600 --> 00:06:03.420口渴的可以加天花粉00:06:03.480 --> 00:06:04.600痰多了呢00:06:04.600 --> 00:06:08.740我们可以加点瓜蒌仁佐贝母00:06:09.520 --> 00:06:12.600高热的患者可以加我们的石生石膏00:06:12.600 --> 00:06:16.600知母啊咽部肿的比较厉害的病人00:06:16.600 --> 00:06:18.800可以我们加牡丹皮啊00:06:18.800 --> 00:06:20.020或者是赤芍00:06:24.040 --> 00:06:27.200嗯中医药在合璧中的应用00:06:27.200 --> 00:06:28.560中医药特色的应用00:06:28.560 --> 00:06:30.180一个是吹喉法00:06:30.400 --> 00:06:33.320将药物研磨成很细00:06:33.320 --> 00:06:36.160很细的那种极细的粉末嗯00:06:36.160 --> 00:06:38.420吹于患者的患部00:06:38.960 --> 00:06:41.460以起到清热利咽00:06:41.800 --> 00:06:43.700消肿止痛的作用00:06:43.720 --> 00:06:45.640常用的药物呢啊00:06:45.640 --> 00:06:47.420如山尿喉棘散00:06:47.520 --> 00:06:48.820喉糠散00:06:49.040 --> 00:06:53.460不含西瓜霜冰硼散及犀利散等药物00:06:54.240 --> 00:06:55.100函数法00:06:55.120 --> 00:06:57.900就是将清热解毒作用的中药00:06:58.320 --> 00:07:00.100煎熬成汤剂00:07:00.520 --> 00:07:01.900或者是提取00:07:02.560 --> 00:07:05.240提取呢它有效的成分啊00:07:05.240 --> 00:07:07.960赤贝成水剂进行平复啊00:07:07.960 --> 00:07:12.200频频的洗漱或者含数啊00:07:12.200 --> 00:07:15.300从而起到呢消肿止痛的作用00:07:15.400 --> 00:07:18.240如淋淋漱口液啊00:07:18.240 --> 00:07:19.460和漱口方00:07:24.120 --> 00:07:27.060含氟法就是像我们中药的制呃00:07:27.280 --> 00:07:29.380中药的制成片剂含氟00:07:29.600 --> 00:07:32.980使药物能在咽部停留较长的时间00:07:33.680 --> 00:07:35.760从而发挥局部治疗的作用00:07:35.760 --> 00:07:38.960我们常常不要用的有那个咽喉片00:07:38.960 --> 00:07:41.140或者草珊瑚含片00:07:41.240 --> 00:07:42.740银黄含化片00:07:43.280 --> 00:07:46.140薄荷喉片等等等等药物00:07:47.200 --> 00:07:47.480嗯00:07:47.480 --> 00:07:51.580还有一种是蒸汽吸入或超声雾化法00:07:51.680 --> 00:07:52.240就是将00:07:52.240 --> 00:07:56.020清热解毒和消肿止痛作用的中药00:07:56.560 --> 00:07:59.380呃煎汤反复过滤00:07:59.840 --> 00:08:02.760取过滤液进行蒸汽呃蒸汽00:08:02.760 --> 00:08:06.220然后吸入或是或者是超声雾化00:08:06.320 --> 00:08:09.600使药物直接啊作用于我们的咽部00:08:09.600 --> 00:08:12.060从而发挥它治疗的作用00:08:12.680 --> 00:08:13.580嗯00:08:15.040 --> 00:08:16.900斑剂如银花00:08:17.080 --> 00:08:19.380大青叶黄芩00:08:19.440 --> 00:08:21.040信节牛郎子00:08:21.040 --> 00:08:23.380甘草等药物00:08:24.480 --> 00:08:26.880嗯针灸点刺放血法00:08:26.880 --> 00:08:30.680就是用三棱针或者是5号的注射针00:08:30.680 --> 00:08:33.560头在两侧的耳尖00:08:33.560 --> 00:08:37.400也就是耳廓上缘的中点以及少山穴00:08:37.400 --> 00:08:40.580点刺挤出恶血数滴00:08:40.880 --> 00:08:42.340每日一次00:08:42.839 --> 00:08:45.580有显著的利咽止痛的作用00:08:52.080 --> 00:08:53.460嗯总结的00:08:54.760 --> 00:08:56.200总结的要点呢00:08:56.200 --> 00:08:59.560就是我们的喉壁呢00:08:59.560 --> 00:09:02.340或者是阴外部倾斜西00:09:02.520 --> 00:09:06.980包括风寒暑湿燥00:09:07.200 --> 00:09:09.000六火00:09:09.000 --> 00:09:11.060六呃六淫邪气00:09:11.160 --> 00:09:14.480这些邪气与正正气交正00:09:14.480 --> 00:09:19.540导致上焦表为诸鞘闭塞不通00:09:20.040 --> 00:09:22.820出现咽喉部临床症状00:09:23.440 --> 00:09:26.460正气虚弱则含包呃00:09:26.600 --> 00:09:28.220包含了经血00:09:29.720 --> 00:09:32.700阳性风顺推动功能不足00:09:32.920 --> 00:09:38.320和经血阴性呃润养润眼健00:09:38.320 --> 00:09:42.220而润健的功能不足两个方面导致00:09:42.600 --> 00:09:45.040这些都是导致一些水症00:09:45.040 --> 00:09:45.840寒症00:09:46.000 --> 00:09:49.340或者是火症为主要临床标现的症状00:09:49.400 --> 00:09:50.740如痰结等00:09:51.160 --> 00:09:51.520此外00:09:51.520 --> 00:09:55.780喉壁病的发生还与气候的剧烈变化00:09:56.000 --> 00:09:58.700以及起居不慎风邪00:09:58.840 --> 00:10:00.220风邪清晰00:10:01.200 --> 00:10:02.460风味湿估00:10:02.640 --> 00:10:06.420以及脏腑的虚损等因素有关00:10:06.880 --> 00:10:10.060嗯针对其可开展的药物治疗00:10:10.720 --> 00:10:12.740根据不同的症候00:10:13.360 --> 00:10:16.540应用不同的中药辨证实质00:10:17.760 --> 00:10:20.500如如祛风清热00:10:20.840 --> 00:10:26.640疏风散寒泻呃泻热解毒等等00:10:26.640 --> 00:10:28.020功效的药物00:10:28.280 --> 00:10:30.180以及非药物治疗00:10:30.600 --> 00:10:34.340包括吹喉函数00:10:34.920 --> 00:10:35.940针灸00:10:36.560 --> 00:10:40.380推拿等疗法00:10:41.120 --> 00:10:46.260也可用吸吸蒸汽吸入00:10:46.520 --> 00:10:51.700或者是超级超声雾化法等00:10:53.960 --> 00:10:56.380还可以我们用那个外啊00:10:57.440 --> 00:10:59.840可以用我们那个中医特色的疗法00:10:59.840 --> 00:11:02.240的矩阵来进行治疗00:11:02.240 --> 00:11:06.400包括我们的内置灸法以及包00:11:06.400 --> 00:11:07.000内置灸法00:11:07.000 --> 00:11:09.300包括是一个是经典的方阵00:11:09.640 --> 00:11:10.440嗯00:11:10.920 --> 00:11:12.560从三行论的桔梗汤00:11:12.560 --> 00:11:15.600到清代的经验方啊00:11:15.600 --> 00:11:18.760药物配对的方法就是玄参加姜啊00:11:18.760 --> 00:11:19.560姜蝉这个00:11:19.560 --> 00:11:21.080木蝴蝶金凤凰00:11:21.080 --> 00:11:23.000一现代的制药呢00:11:23.000 --> 00:11:25.720就是金呃金嗓利阴00:11:25.720 --> 00:11:29.220黄呃清音帝王等的呃那个00:11:29.360 --> 00:11:30.160嗯00:11:31.160 --> 00:11:33.000目前临床大数据分析00:11:33.000 --> 00:11:35.060他们效果还是不错的00:11:35.680 --> 00:11:37.300以及外置六翼00:11:37.320 --> 00:11:38.480也就是我刚刚提00:11:38.480 --> 00:11:40.720到的一个是超声雾化00:11:40.720 --> 00:11:43.100比如讲鱼腥草加薄荷注射液00:11:43.680 --> 00:11:45.240一个闹治法啊00:11:45.240 --> 00:11:46.600或者是呃00:11:46.600 --> 00:11:49.160这个是针对我们淋巴有呃00:11:49.160 --> 00:11:51.080滤泡有增生的患者进行闹治法00:11:51.080 --> 00:11:52.340一个着治法00:11:52.600 --> 00:11:54.520是我们扁桃体呃00:11:54.520 --> 00:11:56.820区域放血的一个种疗法00:11:57.280 --> 00:11:58.640一个穴位敷贴00:11:58.640 --> 00:12:00.960就是在我们天突穴或是列缺穴00:12:00.960 --> 00:12:05.500用紫金锭啊穴穴位的穴位贴00:12:05.960 --> 00:12:07.860还有一种是导引疗法00:12:08.520 --> 00:12:09.040导引疗法00:12:09.040 --> 00:12:13.740就是我们赤龙角海生生经润喉法00:12:14.800 --> 00:12:17.320还有一种是我们茶饮的一种方案00:12:17.320 --> 00:12:20.840就是全参3克加七仙果两克00:12:20.840 --> 00:12:22.820加陈皮一克代茶饮00:12:28.600 --> 00:12:32.840我们是从研究光武阴到现代科学00:12:32.840 --> 00:12:35.280我们中医对阴炎的治疗00:12:35.280 --> 00:12:38.700始终进行治病求本的理念00:12:39.560 --> 00:12:43.380当我们用呃银翘散化解热时00:12:43.440 --> 00:12:44.560是延续了00:12:44.560 --> 00:12:47.040我们吴鞠通教授的一个智慧00:12:47.040 --> 00:12:49.280当我们用到灰烟毒汤时00:12:49.280 --> 00:12:50.160我们是实现了00:12:50.160 --> 00:12:53.560我们以前完清主任的创新精神00:12:53.560 --> 00:12:55.480让我们古老的医学00:12:55.480 --> 00:12:58.640在现代咽啊咽喉疾病的繁殖中00:12:58.640 --> 00:13:03.500继续谱写了一个简便应联的新篇章00:13:10.920 --> 00:13:12.360同时我们还要用00:13:12.360 --> 00:13:15.120我们还用四维的辨证模型00:13:15.120 --> 00:13:17.520来辨证我们这个疾病00:13:17.520 --> 00:13:20.460一个一个是风热外吸症00:13:20.880 --> 00:13:21.760它的要点呢00:13:21.760 --> 00:13:26.180是阴痛灼热淹没春雪傍了00:13:26.200 --> 00:13:29.660嗯发寒恶热嗯00:13:31.320 --> 00:13:33.280目前主要的治疗那个方药呢00:13:33.280 --> 00:13:36.320是啊疏风清热盈窍散00:13:36.320 --> 00:13:38.700合旋麦桔梗汤00:13:39.200 --> 00:13:40.640这是肺热热症型00:13:40.640 --> 00:13:42.440我们刚才提到的啊00:13:42.440 --> 00:13:44.040就是咽喉疼痛00:13:44.040 --> 00:13:46.340剧烈便秘口臭00:13:46.720 --> 00:13:49.260以及麦红散麦红素00:13:50.760 --> 00:13:54.240嗯目前我们临床数据显示啊00:13:54.240 --> 00:13:58.340配合穴位的放穴可以缩短病程3-5天00:13:59.360 --> 00:14:01.480嗯治疗的方药呢00:14:01.480 --> 00:14:04.500一个是通苦泻热清阴利葛汤00:14:04.640 --> 00:14:08.340联合呃少山穴的点刺00:14:10.920 --> 00:14:11.480第三个呢00:14:11.480 --> 00:14:13.800是肺肾阴虚证啊他00:14:13.800 --> 00:14:17.620辨别的要点呢是咽干灼痒00:14:18.880 --> 00:14:20.180啊唇轻目重00:14:20.360 --> 00:14:21.240早上比较轻00:14:21.240 --> 00:14:21.960晚上比较重00:14:21.960 --> 00:14:23.020唇轻目重00:14:23.120 --> 00:14:24.740已经舌红少尖00:14:25.320 --> 00:14:29.160目前我们的特色疗法呢是归引火00:14:29.160 --> 00:14:30.460归归元法00:14:31.120 --> 00:14:33.900就是滋肾王行服00:14:34.000 --> 00:14:38.660加上我们的呃涌泉穴的贴服00:14:42.080 --> 00:14:45.100介绍的方药呢是滋养啊00:14:45.240 --> 00:14:46.580滋阴降火00:14:47.800 --> 00:14:49.580养阴清肺汤00:14:49.720 --> 00:14:52.980呃以及合用我们的滋补地黄丸00:14:55.040 --> 00:14:57.320第四个是我们贪欲护呃00:14:57.320 --> 00:14:58.580护护结症00:14:59.440 --> 00:15:00.360辨别的要点呢00:15:00.360 --> 00:15:03.180就是我们这个阴梗异物感00:15:03.640 --> 00:15:06.180黏黏膜暗红肥厚00:15:08.880 --> 00:15:10.720目前我们用了药呃00:15:10.720 --> 00:15:13.680药物一个是汇阴足浴汤啊00:15:13.680 --> 00:15:17.060联合我们的海藻玉芍汤现在的00:15:17.560 --> 00:15:18.460嗯00:15:19.040 --> 00:15:20.120有证据证明00:15:20.120 --> 00:15:20.940包括我们00:15:20.960 --> 00:15:23.920我们用于纤维场景的显示可以改善00:15:23.920 --> 00:15:25.720我们滤泡增生可以改善00:15:25.720 --> 00:15:27.940有效率达到89%00:15:31.000 --> 00:15:33.060嗯通通过我们00:15:33.400 --> 00:15:36.120我们中医医生那个精准的辨认呢00:15:36.120 --> 00:15:37.080为我们疾病呢00:15:37.080 --> 00:15:39.100绘画了一个中医的画像00:15:39.280 --> 00:15:40.040而中药呢00:15:40.040 --> 00:15:40.440是我们00:15:40.440 --> 00:15:43.680这个我们中医的神奇的画笔00:15:43.680 --> 00:15:44.960让我们共同见证00:15:44.960 --> 00:15:47.220我们中医药的临床魅力00:15:47.600 --> 00:15:48.500谢谢大家00:15:48.600 --> 00:15:50.020今天就讲到这里