从《临证指南医案》论叶天士“辨治胃阳”思想及特色
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摘要
叶天士在《临证指南医案》中对脾胃病进行了详细的论述,以阴阳为纲,创立了"胃阴学说",受到后世医家的关注。同时,叶天士亦重视胃腑之阳气,诊治胃阳虚医案众多,病因病机多有阳明不运、中焦失司,胃土失用、脏腑失和,胃络失守、气血失调等方面;在证治上提出通补阳明、调和脏腑、补虚通络等要法;用药则善刚柔相济,喜以薄味之品相通,对诊治脾胃系统疾病有一定指导意义。
YE Tianshi discussed the spleen and stomach diseases in detail in Guide to Clinical Practice with Medical Records( 《临证指南医案》),taking yin and yang as the principle,he established the "theory of stomach yin",which was focused and studied by later physicians. Meanwhile,it is believed that YE Tianshi attaches importance to yang qi in the stomach fu organs,and has many medical cases for the diagnosis and treatment of stomach yang deficiency. The etiology and pathogenesis are mainly yangming's failure to transport,loss control of middle jiao,malfunction of stomach earth,disharmony of zang organs and fu organs,loss defense of stomach collaterals,imbalance of qi and blood,etc. In the treatment of syndrome,he puts forward some important methods,such as dredging yangming,harmonizing zang organs and fu organs,tonifying deficiency and dredging collaterals. The drugs are good at combining hardness with softness,preferring to be combined with drugs of thin flavor,which has a certain guiding significance to the diagnosis and treatment of the spleen and stomach system diseases.
YE Tianshi discussed the spleen and stomach diseases in detail in Guide to Clinical Practice with Medical Records( 《临证指南医案》),taking yin and yang as the principle,he established the "theory of stomach yin",which was focused and studied by later physicians. Meanwhile,it is believed that YE Tianshi attaches importance to yang qi in the stomach fu organs,and has many medical cases for the diagnosis and treatment of stomach yang deficiency. The etiology and pathogenesis are mainly yangming's failure to transport,loss control of middle jiao,malfunction of stomach earth,disharmony of zang organs and fu organs,loss defense of stomach collaterals,imbalance of qi and blood,etc. In the treatment of syndrome,he puts forward some important methods,such as dredging yangming,harmonizing zang organs and fu organs,tonifying deficiency and dredging collaterals. The drugs are good at combining hardness with softness,preferring to be combined with drugs of thin flavor,which has a certain guiding significance to the diagnosis and treatment of the spleen and stomach system diseases.
引文
[1]曹刘,张佳缘.胃阴学说源流及其理论意义辨析[J].南京中医药大学学报,2018,34(4):337-339.
[2]叶天士.叶天士医学全书[M].黄英志,主编.北京:中国中医药出版社,1999.
[3]黄元御.四圣心源[M].北京:人民军医出版社,2013:3.
[4]孙华敏,吕翠霞.浅谈胃阳虚辨证论治[J].山东中医药大学学报,2012,36(3):193-194.
[5]沈堂彪,骆仙芳.叶天士理胃阳法浅识[J].浙江中医学院学报,1993,17(4):39.
[6]于磊.叶天士对张仲景脾胃思想的继承与发展[J].河南中医,2018,38(9):1344-1346.
[7]张达坤,朱慧婷,邝卫红.从叶案谈通补阳明法[J].新中医,2011,43(1):134-135.
[8]吕英,李爱武,成云水.立足气一元论从厥阴、阳明论治晚期癌症[J].中华中医药杂志,2015,30(3):782-784.
[9]高金柱,高雅蓓,苗青,等.叶天士脾胃论治慢性咳嗽的学术思想[J].世界中医药,2013,8(1):29-30.
[10]李佩佩,庄美佳,杨葛巍.叶天士《临证指南医案》咳嗽辨治思路及特色探析[J].甘肃中医药大学学报,2017,34(2):46-47.
[11]林敏.《临证指南医案》络病辨治规律研究[D].福州:福建中医药大学,2017:9.
[12]彭君伟,周帆,李红琳,等.叶天士从络病理论辨治胃脘痛思路探析[J].四川中医,2018,36(10):28-30.
[13]张文选.叶天士用经方[M].北京:人民卫生出版社,2011:14.
[14]杨豪杰,孙芳园,马金苗,等.茯苓通胃阳探析[J].吉林中医药,2015,35(9):952-955.
[15]宋增强,冯松杰.“轻可去实”学说理论探讨[J].长春中医药大学学报,2007,23(4):1-3.
[2]叶天士.叶天士医学全书[M].黄英志,主编.北京:中国中医药出版社,1999.
[3]黄元御.四圣心源[M].北京:人民军医出版社,2013:3.
[4]孙华敏,吕翠霞.浅谈胃阳虚辨证论治[J].山东中医药大学学报,2012,36(3):193-194.
[5]沈堂彪,骆仙芳.叶天士理胃阳法浅识[J].浙江中医学院学报,1993,17(4):39.
[6]于磊.叶天士对张仲景脾胃思想的继承与发展[J].河南中医,2018,38(9):1344-1346.
[7]张达坤,朱慧婷,邝卫红.从叶案谈通补阳明法[J].新中医,2011,43(1):134-135.
[8]吕英,李爱武,成云水.立足气一元论从厥阴、阳明论治晚期癌症[J].中华中医药杂志,2015,30(3):782-784.
[9]高金柱,高雅蓓,苗青,等.叶天士脾胃论治慢性咳嗽的学术思想[J].世界中医药,2013,8(1):29-30.
[10]李佩佩,庄美佳,杨葛巍.叶天士《临证指南医案》咳嗽辨治思路及特色探析[J].甘肃中医药大学学报,2017,34(2):46-47.
[11]林敏.《临证指南医案》络病辨治规律研究[D].福州:福建中医药大学,2017:9.
[12]彭君伟,周帆,李红琳,等.叶天士从络病理论辨治胃脘痛思路探析[J].四川中医,2018,36(10):28-30.
[13]张文选.叶天士用经方[M].北京:人民卫生出版社,2011:14.
[14]杨豪杰,孙芳园,马金苗,等.茯苓通胃阳探析[J].吉林中医药,2015,35(9):952-955.
[15]宋增强,冯松杰.“轻可去实”学说理论探讨[J].长春中医药大学学报,2007,23(4):1-3.
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