叶天士通阳散结法辨治胸痹心痛探析
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摘要
胸痹心痛是现代临床上较为多见的病症之一,与现代医学"冠心病"的症状类似。其病因病机多为上焦心阳虚衰、下焦阴寒上乘。本文通过研究《叶氏医衡》、《临证指南医案》、《叶桂医案存真》等著作中有关胸痹心痛的论述及医案,发现叶天士通阳散结治疗胸痹心痛上承仲景之法和历代先贤的研究,注重温通,下启"血络痹痛"与"涌痰法",提出"久痛必入络"、"痛久入血络"以及"涌吐痰涎"等观点,同时兼顾脾胃、寓通于补,注重情志因素,发展了胸痹心痛的病因病机和辨证论治理论。叶氏用药平淡简易但疗效颇佳,其辨治胸痹心痛的思路依然具有指导意义。
Chest pain is one of the most common clinical conditions in modern times.It is similar to the symptoms of modern medical "coronary heart disease".The etiology and pathogenesis of the disease is mostly the ups and downs of the heart and the Yin and the cold.This article explores the discussion of chest pain and heart disease in the works of "YE Medical Balance","Clinical Medicine Case","YE Gui Medical Case",and discovers that YE Tianshi Tongyang Sanjie treatment of chest pain.CHENG Zhongjing's method and the study of the sages of the past dynasties,paying attention to Wentong,starting the "Blood stagnation and pain" and "fever sputum",proposing that "long pain will enter the network","painful into the blood" and "excretion sputum" and other viewpoints,while taking into account the spleen and stomach,through the supplement,focus on emotional factors,the development of the chest and heart pain pathogenesis and syndrome differentiation theory.Yip's medication is simple and simple,but the curative effect is quite good.The idea of distinguishing and treating chest pain is still instructive.
Chest pain is one of the most common clinical conditions in modern times.It is similar to the symptoms of modern medical "coronary heart disease".The etiology and pathogenesis of the disease is mostly the ups and downs of the heart and the Yin and the cold.This article explores the discussion of chest pain and heart disease in the works of "YE Medical Balance","Clinical Medicine Case","YE Gui Medical Case",and discovers that YE Tianshi Tongyang Sanjie treatment of chest pain.CHENG Zhongjing's method and the study of the sages of the past dynasties,paying attention to Wentong,starting the "Blood stagnation and pain" and "fever sputum",proposing that "long pain will enter the network","painful into the blood" and "excretion sputum" and other viewpoints,while taking into account the spleen and stomach,through the supplement,focus on emotional factors,the development of the chest and heart pain pathogenesis and syndrome differentiation theory.Yip's medication is simple and simple,but the curative effect is quite good.The idea of distinguishing and treating chest pain is still instructive.
引文
[1]叶天士.临证指南医案[M].徐灵胎,评.上海:上海科学技术出版社,1959
[2]袁琛皓,李秋恒,高燕.基于中医传承辅助系统分析李秋恒教授治疗胸痹心痛用药规律[J].中西医结合心脑血管病杂志,2017,15(16):1985-1989.
[3]张仲景.金匮要略[M].何任等,整理.北京:人民卫生出版社,2005:31
[4]邵慧瑾,秦琬玲,施恒.明清医家胸痹心痛诊治特点[J].江西中医药,2015,46(5):3-5.
[5]张学新,刘艳军,李俊,等.中医通法治疗胸痹的学术思想探析[J].中西医结合心血管病电子杂志,2016,4(21):129-130.
[6]谢华.黄帝内经释义[M].北京:中医古籍出版社,2000:504
[7]周炜,王居易.王居易同名经对穴理论及其临床应用[J].中国中医药信息杂志,2015,27(7):109-111.
[8]刘云.基于中医传承辅助系统甘爱萍教授治疗老年功能性便秘药证规律研究[D].武汉:湖北中医药大学,2017.
[9]梁丽君.脾胃系温病气机失调的辨治规律研究[D].太原:山西中医学院,2016.
[10]刘佳玉,石克华,吴银根.从“肺胃相关,肺病治胃”治疗胃食管反流性咳嗽验案[J].山东中医杂志,2017,36(10):900-901.
[11]崔欣.基于仲景情志病证治理论的焦虑症病因病机研究[D].济南:山东中医药大学,2014.
[2]袁琛皓,李秋恒,高燕.基于中医传承辅助系统分析李秋恒教授治疗胸痹心痛用药规律[J].中西医结合心脑血管病杂志,2017,15(16):1985-1989.
[3]张仲景.金匮要略[M].何任等,整理.北京:人民卫生出版社,2005:31
[4]邵慧瑾,秦琬玲,施恒.明清医家胸痹心痛诊治特点[J].江西中医药,2015,46(5):3-5.
[5]张学新,刘艳军,李俊,等.中医通法治疗胸痹的学术思想探析[J].中西医结合心血管病电子杂志,2016,4(21):129-130.
[6]谢华.黄帝内经释义[M].北京:中医古籍出版社,2000:504
[7]周炜,王居易.王居易同名经对穴理论及其临床应用[J].中国中医药信息杂志,2015,27(7):109-111.
[8]刘云.基于中医传承辅助系统甘爱萍教授治疗老年功能性便秘药证规律研究[D].武汉:湖北中医药大学,2017.
[9]梁丽君.脾胃系温病气机失调的辨治规律研究[D].太原:山西中医学院,2016.
[10]刘佳玉,石克华,吴银根.从“肺胃相关,肺病治胃”治疗胃食管反流性咳嗽验案[J].山东中医杂志,2017,36(10):900-901.
[11]崔欣.基于仲景情志病证治理论的焦虑症病因病机研究[D].济南:山东中医药大学,2014.