王行宽治疗慢性神经性耳鸣经验

王行宽治疗慢性神经性耳鸣经验

王行宽教授认为，慢性神经性耳鸣多由于机体正气不足，风邪趁机而入，上犯清窍，风吹裂隙则鸣。辨证分为肾虚精亏、髓海不足，心肝血虚、脉络空虚，脾气虚陷、清阳不升，血脉瘀滞、痰火壅结。治疗上，王教授擅长在辨证论治基础上以治一脏或二脏为主，兼顾调节他脏，即多脏调燮。此外，王教授倡导“杂病治肝”的学术观点，治病不忘疏泄调达肝木。

Abstract：Professor WANG Xing-kuan holds the idea that chronic nervous tinnitus is mainly due to this cause：when the body is lack of zheng-qi （positive qi），the wind-evil finds the cracks and enters healthy body，which may affect Qingqiao，and then the wind-evil will get into Qingqiao and result in tinnitus. The syndrome is further differentiated into the following types：kidney deficiency，insufficiency of brain，deficiency of heart and liver blood，meridian emptiness，deficiency of spleen qi，descending of yang qi；blood stasis and phlegm-fire accumulation. In treatment，Professor WANG is good at treating one or two viscera based on diagnosis and treatment through syndrome differentiation，taking into account of the regulation of other internal organs，namely，method for regulating multiple organs. In addition，Professor WANG advocat es the academic view of “treating diseases by regulating the liver”，never forgetting the catharsis of liver wood.

Keywords：experience of famous doctors；WANG Xing-kuan；nervous tinnitus

湖南中医药大学第一附属医院王行宽教授系全国老中医药专家学术经验继承第二、三、四、五批指导老师，精研阴阳五行学说，深谙其相互消长、生化、制约之理，尤其洞晓五脏相关学说，治病擅长采用“隔一脏、隔二脏甚至隔三脏，多脏调燮、综合治理”之法；另外，王教授非常重视社会、心理因素对疾病的影响，注重肝脏生理功能与病理变化对他脏及整个病情的影响，倡导“杂病治肝”的学术观点[1]。临证50余载，精于临床常见病及疑难杂病诊治，名噪潇湘。兹就其治疗慢性神经性耳鸣经验介绍如下。

1 中西医对神经性耳鸣的认识

中医将神经性耳鸣归于耳鸣论治。耳鸣作为症状，古医籍有不同描述，如“聊啾”“脑鸣”“耳数鸣”等[2]。《杂病源流犀烛·耳病源流》描述为：“其鸣也，

或如蝉鸣，或如钟鼓，或如水激，不一而足。”关于耳鸣的病因病机，《内经》从与脏腑经络的关系作了论述。

从西医学角度看，神经性耳鸣是一种听觉紊乱的现象，是在无任何外界刺激条件下，患者主观听到的各种声响，如风声、蝉声、潮水声等。近年来，随着社会生活节奏加快，以及工作压力、人际关系、噪声污染等诸多因素作用下，神经