从《王仲奇医案》探讨王仲奇“苦辛法”运用经验
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摘要
[目的]从《王仲奇医案》郁证、呕吐、咳嗽、脘腹痞痛、湿温等五个方面探析王仲奇苦辛法治疗多种疾病的特色,以期学习、传承王氏学术思想精华与临证诊治特点。[方法]以《王仲奇医案》所载医案为基础,结合《内经》《伤寒论》张景岳、李东垣、叶桂及王仲奇经典论述与学术思想等,阐述例案所示王氏运用"苦辛法"治疗疾病的经验,并综合分析其诊治特点。[结果]王氏继承张仲景、叶天士等医家运用苦辛法的经验和认识,师古却不泥古,郁则气滞,辛开苦降开枢机;气逆呕吐,苦降辛通达气机;咳嗽气逆,辛苦宣泄肃肺气;脘腹痞、痛,苦辛通降调中焦;湿热弥漫,轻苦微辛调气机。[结论]王氏宗《内经》、仲景、东垣、叶桂诸家之长,多有创新,治法灵活。将苦辛法运用到多种气机升降失常的疾病的治疗中,通过条畅气机,而达到气化湿化、气行血行等效果,而祛除体内的病邪,临床取得较好效果,值得深入研究。
[Objective] From the five aspects of WANG Zhongqi medical case, such as Qi syndrome, vomiting, cough, epigastric pain, wet temperature and so on, WANG Zhong Qi's bitterness in the treatment of various diseases, in order to learn and inherit the essence of WANG's academic thought and the characteristics of clinical diagnosis and treatment. [Methods] On the basis of the medical case contained in "WANG Zhongqi's Medical Cases", combined with classic treatise and academic thought of "Neijing", "Treatise on Typhoid Fever", ZHANG Jingyue, LI Dongyuan, YE Guangxi and WANG Zhongqi,this paper illustrates WANG's experience in the treatment of disease with "bitterness method" and analyzes the characteristics of the diagnosis and treatment. [Results] WANG inherited the experience and understanding of ZHANG Zhongjing, YE Tianshi and other doctors in the use of the method of bitterness, but didn't learn without change, depression causing Qi stagnation and bitter opening the pivot; Qi reverse vomiting, bitter descending pungent openning and promoting Qi function; cough of Qi inverse, pungent and bitter having catharsis to purge the lung Qi; for epigastric stomach pain, bitterness regulating middle warmer; damp heat diffusing, light bitter micro pungent regulating Qi function. [Conclusion] WANG's referred to "Neijing", Zhongjing,Dongyuan and YE Gui and had many innovations and flexible methods. It is worthy of further study to apply the method of bittern to the treatment of a variety of dysfunctional diseases of Qi, through the effect of the gasification and blood flow for regulating Qi function, to remove the pathogenic pathogenic factors in the body.
[Objective] From the five aspects of WANG Zhongqi medical case, such as Qi syndrome, vomiting, cough, epigastric pain, wet temperature and so on, WANG Zhong Qi's bitterness in the treatment of various diseases, in order to learn and inherit the essence of WANG's academic thought and the characteristics of clinical diagnosis and treatment. [Methods] On the basis of the medical case contained in "WANG Zhongqi's Medical Cases", combined with classic treatise and academic thought of "Neijing", "Treatise on Typhoid Fever", ZHANG Jingyue, LI Dongyuan, YE Guangxi and WANG Zhongqi,this paper illustrates WANG's experience in the treatment of disease with "bitterness method" and analyzes the characteristics of the diagnosis and treatment. [Results] WANG inherited the experience and understanding of ZHANG Zhongjing, YE Tianshi and other doctors in the use of the method of bitterness, but didn't learn without change, depression causing Qi stagnation and bitter opening the pivot; Qi reverse vomiting, bitter descending pungent openning and promoting Qi function; cough of Qi inverse, pungent and bitter having catharsis to purge the lung Qi; for epigastric stomach pain, bitterness regulating middle warmer; damp heat diffusing, light bitter micro pungent regulating Qi function. [Conclusion] WANG's referred to "Neijing", Zhongjing,Dongyuan and YE Gui and had many innovations and flexible methods. It is worthy of further study to apply the method of bittern to the treatment of a variety of dysfunctional diseases of Qi, through the effect of the gasification and blood flow for regulating Qi function, to remove the pathogenic pathogenic factors in the body.
引文
[1]聂多锐,刘兰林,郭锦晨,等.基于《王仲奇医案》探析王仲奇"运脾"辨治胀满特色[J].甘肃中医药大学学报,2017,34(4):17-19.
[2]陈良,仝小林,徐远.从辛开苦降法论治消渴[J].新中医2006,38(2):1-3.
[3]王道成.辛开苦降法及其临床运用[J].吉林中医药,201030(3):209-210.
[4]杨洋,魏玮,史海霞.开苦降法治疗脾胃病[J].中医杂志2016,57(5):446-447.
[5]叶天士.临证指南医案[M].苏礼,整理.北京:人民卫生出版社,2006:276.
[6]张志明"分消走泄"法初步探讨[J].江西中医学院学报2011,23(2):28-30.
[7]张锡纯.医学衷中参西录[M].柳西河,重订.北京:人民卫生出版社,2006:105.
[8]魏道祥.瓜萎燕白半夏剂的临床应用探析[J].辽宁中医杂志,2002,29(5):293-294
[9]王军仓,章贵卿.辛开苦降法治疗小儿喘息性肺炎98例疗效观察[J].新中医,2010,42(6):26-27.
[10]陈良,仝小林,徐远,等.从辛开苦降法论治消渴[J].新中医,2006,38(2):1-3.
[11]刘立亭,陈宪海,甄维帅,等."辛开苦降法"肺系病应用浅析[J].亚太传统医药,2014,10(5):68-69.
[12]魏玮,郝建军,周晓莉.辛开苦降法与脾升胃降[J].中医杂志,2004,45(9):715-716.
[13]李冀,毕君辉.浅析脾胃气机升降[J].中医药信息,2005,22(6):1-2.
[14]钟燕春,杨进.叶薛二氏论治湿温之异同[J].中华中医药杂志,2012,27(3):534-536.
[15]陈志伟,翟玉祥.叶天士运用辛开苦降法治疗温热病[J].吉林中医药,2008,28(12):865-866.
[16]魏铭,刘立华.气机升降与肺脾病证[J].实用中医内科杂志,2013,27(1):57-59.
[17]唐学游.辛开苦降法是调理气机的大法[J].中医杂志,1994,41(3):184.
[2]陈良,仝小林,徐远.从辛开苦降法论治消渴[J].新中医2006,38(2):1-3.
[3]王道成.辛开苦降法及其临床运用[J].吉林中医药,201030(3):209-210.
[4]杨洋,魏玮,史海霞.开苦降法治疗脾胃病[J].中医杂志2016,57(5):446-447.
[5]叶天士.临证指南医案[M].苏礼,整理.北京:人民卫生出版社,2006:276.
[6]张志明"分消走泄"法初步探讨[J].江西中医学院学报2011,23(2):28-30.
[7]张锡纯.医学衷中参西录[M].柳西河,重订.北京:人民卫生出版社,2006:105.
[8]魏道祥.瓜萎燕白半夏剂的临床应用探析[J].辽宁中医杂志,2002,29(5):293-294
[9]王军仓,章贵卿.辛开苦降法治疗小儿喘息性肺炎98例疗效观察[J].新中医,2010,42(6):26-27.
[10]陈良,仝小林,徐远,等.从辛开苦降法论治消渴[J].新中医,2006,38(2):1-3.
[11]刘立亭,陈宪海,甄维帅,等."辛开苦降法"肺系病应用浅析[J].亚太传统医药,2014,10(5):68-69.
[12]魏玮,郝建军,周晓莉.辛开苦降法与脾升胃降[J].中医杂志,2004,45(9):715-716.
[13]李冀,毕君辉.浅析脾胃气机升降[J].中医药信息,2005,22(6):1-2.
[14]钟燕春,杨进.叶薛二氏论治湿温之异同[J].中华中医药杂志,2012,27(3):534-536.
[15]陈志伟,翟玉祥.叶天士运用辛开苦降法治疗温热病[J].吉林中医药,2008,28(12):865-866.
[16]魏铭,刘立华.气机升降与肺脾病证[J].实用中医内科杂志,2013,27(1):57-59.
[17]唐学游.辛开苦降法是调理气机的大法[J].中医杂志,1994,41(3):184.