Dr浅岡俊之の漢方 東洋医学の考え方
Dr浅岡俊之の漢方 東洋医学の考え方
●漢方が何故難しいのか?
ほとんどの医師は基礎がないから
東洋医学の論理(ソフト)が必要
●東洋医学の特徴
・必要なポイント
漢方の視点
ハード(コンピューター、薬)が違えばソフト(OS、論理)が違う
・西洋医学
パーツに分析 →診断「病名」
パーツの治療を積み重ねる
・東洋医学
全体を診る →診断「証」 …状態 例「悪寒→咳→下痢 → etc」
その状態をbest(中庸)に持っていこうと治療する
例:肝炎
西洋医学: HAV、HBV、HCV、etc
…一昔前、肝炎全てに小柴胡湯をしたり、西洋医学ではやってしまう
responder と nonresponder がいる。
そして3万件に1件の間質性肺炎があったからと、
「小柴胡湯は間質性肺炎の原因となる」としてしまったりする
●東洋医学・漢方薬は、 「てこ」ではなく「ベクトル」
必要なのは診断名 ではなく 病態・状態・病期を見抜く
東洋医学は個体差を考える
西洋医学は画一的な投与方法で確率論で勝負
東洋医学は 全てを見抜いて単剤で勝負
(病期・病態、病期の進行・軽快にあわせて変える)
西洋医学は 症状を分析して症状を抑える薬を
●関節痛
熱 → エッピカジュツトウ
寒 → ケイシカジュツブトウ
●下痢
熱 → サイレイトウ
寒 → 真武湯
●陽
老人性ソウヨウ症
湿り気が足りなくなって痒くなる → 陰虚
小柴胡湯
裏熱 虚証 に効果ある
●同病異治
・16歳女性 小児期よりアトピー性皮膚炎、華奢で皮膚は乾燥し、四肢に冷えあり。ストレスで下痢をしやすい
「寒虚燥症、脾虚」
→ 「オウギケンチュウトウ」
・32歳男性 熱感と赤みの強いアトピー性皮膚炎。浸出液も多い。がっちり体型で冷たいものをよく飲む
「熱実湿症」
→ 「オウレンゲドクトウ」
●異病同治
・23歳女性、色白で華奢な体格。月経不順と月経痛が主訴。下腹部に圧痛。時にむくみと冷え
「寒虚湿証 オ血」
・56歳女性 若い頃から冷え性と肩こりに悩んでいる。舌は厚く歯痕あり、時にめまい。体力はあまりない
「寒虚湿証 オ血」
→ 当帰芍薬散
●気血水
【気】
・気の上衝、気逆
イライラ、怒りっぽい、冷えのぼせ
動悸発作、臍の動悸、発作性の嘔吐(嘔気なし)
→ 上に上った気を下げてやる
・気鬱
〜憂鬱になると心窩部が重くなったりする
喉の閉塞感(実は、ひどいストレスに晒されるとよくなる)、鬱傾向、情緒不安
心窩ヒコウ、胸腹部膨満感
・気虚
〜大病の後に気力が消えてしまう
脱力、気力でない、食欲でない、下痢、弱脈、風邪ひきやすい
声に力出ない、日中の眠気、
【血】
・お血
〜血のめぐりが悪い
生殖器で巡らなくて下腹部が痛くなったり
頭で巡らなくなって頭痛くなったり
目の下に隈があったり、
唇の周りが紫色だったり
紅斑・紫斑できやすかったり
痔、生理痛、冷え、下腹部が痛い、
頭痛、のぼせ、
・血虚
〜血による栄養補給不足
「隅々まで栄養がいきわたっていない状態」
集中力低下、脱毛、眼精疲労、皮膚の乾燥、つやがない
爪のヒハク化、指先のあかぎれ、生理異常
典型: 長年人工透析を受けている患者さん
独特のくすんだ皮膚の色
『貧血 ≒ 血虚』
【水】
・水毒
〜水の偏在
上下、表裏、全身 など
例: 「二日酔いの朝」
…顔や手がぱんぱんにむくんでいるが、喉が渇く
「サードスペースに水がたまっているが血管内脱水」
→あまっているところから少ないところに導いてやればいい
→ ゴレイサン
滲出性中耳炎、めまい、歯痕舌、腹部振水音、下痢の傾向、排尿異常、むくみ、関節水腫
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投稿者: Citrate Effect Hytrin Sildenafil | 2011年06月11日 20:06