《伤寒杂病论》眩晕辨治规律探析
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摘要
眩晕作为《伤寒杂病论》中的常见症状,其病因各异,病机复杂,分析《伤寒杂病论》中眩晕有关的条文,按照病机将眩晕分为风火相煽,三焦饮停,膀胱气化阻遏、水湿停聚,阴阳两虚、清空失养,阳气郁闭过重,阴竭阳脱、阴阳离绝六个类型论述,以探讨张仲景对眩晕的辨证论治规律及理法方药特点,眩晕病机复杂多变,病性有阴阳虚实之分:实证多是水湿痰饮为患,虚证多责之脾肾阳虚、精血亏虚。张仲景对于眩晕一证主要从痰饮立论,采用三焦辨证方法治疗痰饮型眩晕,重视中焦脾胃的运化作用,创立了苓桂术甘汤、五苓散、真武汤等多首治疗痰饮型眩晕的经方。
As a common symptom in Treatise on Cold Damage and Miscellaneous Diseases,vertigo has different causes and complicated pathogenesis. Through the analysis of vertigo related articles in Treatise on Cold Damage and Miscellaneous Diseases,according to the pathogenesis,vertigo is divided into six types:internal whirling of wind-fire,fluid retention in Sanjiao,blockage in bladder qi transformation causing water-dampness accumulation,yin and yang deficiency causing failure of the head to be nourished,yang qi depression,yin exhaustion and yang desertion causing yin and yang separation. ZHANG Zhongjing's syndrome differentiation rules,treatment methods and characteristics of prescriptions of vertigo are explored and pointed out that the pathogeneses are diverse. The disease property can be divided into yin,yang,deficiency and excess. The excess mainly refers to water,dampness,phlegm and fluid. The deficiency mainly includes spleen and kidney yang deficiency and essence and blood deficiency. ZHANG Zhongjing treating vertigo is mainly from the theory of phlegm and fluid,using Sanjiao differentiation method to treat vertigo of phlegm and fluid type;paying attention to the transportation and transformation of spleen and stomach. Classical prescription such as Linggui Zhugan Decoction,Wuling Powder and Zhenwu Decoction,ect. are initiated to treat vertigo with phbegrn-fluid type.
As a common symptom in Treatise on Cold Damage and Miscellaneous Diseases,vertigo has different causes and complicated pathogenesis. Through the analysis of vertigo related articles in Treatise on Cold Damage and Miscellaneous Diseases,according to the pathogenesis,vertigo is divided into six types:internal whirling of wind-fire,fluid retention in Sanjiao,blockage in bladder qi transformation causing water-dampness accumulation,yin and yang deficiency causing failure of the head to be nourished,yang qi depression,yin exhaustion and yang desertion causing yin and yang separation. ZHANG Zhongjing's syndrome differentiation rules,treatment methods and characteristics of prescriptions of vertigo are explored and pointed out that the pathogeneses are diverse. The disease property can be divided into yin,yang,deficiency and excess. The excess mainly refers to water,dampness,phlegm and fluid. The deficiency mainly includes spleen and kidney yang deficiency and essence and blood deficiency. ZHANG Zhongjing treating vertigo is mainly from the theory of phlegm and fluid,using Sanjiao differentiation method to treat vertigo of phlegm and fluid type;paying attention to the transportation and transformation of spleen and stomach. Classical prescription such as Linggui Zhugan Decoction,Wuling Powder and Zhenwu Decoction,ect. are initiated to treat vertigo with phbegrn-fluid type.
引文
[1]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:2.
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[3]周媛,杨彦伟,王松鹏,等.经方在治疗眩晕病中的应用[J].中医临床研究,2017,9(1):90-91.
[4]李云峰.眩晕的经方治验体会[J].临床医药文献电子杂志,2014,1(5):740.
[5]沈金波.经方论治眩晕验案四则[J].湖北中医杂志,2013,35(5):47-48.
[6]郭进财,刘雪娜,洪炳根.眩晕病的经方诊治思路[J].中国中医急症,2012,21(7):1111-1112.
[7]韩明亮.浅析张仲景从痰饮论治眩晕[J].河南中医,2010,30(10),944-945
[8]朱广仁,王效菊.《伤寒》《金匮》中眩晕证的探讨[J].浙江中医学院学报,1984,8(3):16-18.
[9]王建康.《伤寒杂病论》痰饮型眩晕之治法与临床运用[J].中医研究,2006,19(7),9-10.
[10]孙得利,刘亚琴.经方治疗阳虚眩晕症辨析[J].中医临床研究,2011,3(19):82.
[11]赵慧.张仲景痰饮眩晕辨治规律及现代运用研究[D].北京:北京中医药大学,2014:43.
[2]董昌武,程维克,万四妹.论《伤寒杂病论》眩晕病证辨治规律[J].安徽中医学院学报,2007,26(4):1-2.
[3]周媛,杨彦伟,王松鹏,等.经方在治疗眩晕病中的应用[J].中医临床研究,2017,9(1):90-91.
[4]李云峰.眩晕的经方治验体会[J].临床医药文献电子杂志,2014,1(5):740.
[5]沈金波.经方论治眩晕验案四则[J].湖北中医杂志,2013,35(5):47-48.
[6]郭进财,刘雪娜,洪炳根.眩晕病的经方诊治思路[J].中国中医急症,2012,21(7):1111-1112.
[7]韩明亮.浅析张仲景从痰饮论治眩晕[J].河南中医,2010,30(10),944-945
[8]朱广仁,王效菊.《伤寒》《金匮》中眩晕证的探讨[J].浙江中医学院学报,1984,8(3):16-18.
[9]王建康.《伤寒杂病论》痰饮型眩晕之治法与临床运用[J].中医研究,2006,19(7),9-10.
[10]孙得利,刘亚琴.经方治疗阳虚眩晕症辨析[J].中医临床研究,2011,3(19):82.
[11]赵慧.张仲景痰饮眩晕辨治规律及现代运用研究[D].北京:北京中医药大学,2014:43.