从张伯礼教授验案看“虚不受补”病证诊疗策略

Diagnostic and therapeutic strategy of “deficiency without tonic” from the case of Professor ZHANG Boli

“虚不受补”作为临床疑难问题散在述评,却欠理法,通过张伯礼教授轻量使用温燥、渗利药即出现口腔溃疡及心悸的病案一则探究“虚不受补”类病证的病因病机、体质特点及治疗策略。此类病证病机多因脏腑虚实夹杂,或兼寒热错杂、气机失调,体质迥异而补不得效,甚则有过,临证治当慎重把握药物偏性,轻量缓图,攻补兼施,标本兼治,制性纠偏,润燥合宜,厘然有度。

As a difficult clinical problem,“deficiency not being able to tolerate tonic”is scattered in some literature,but there is a lack of systematic literature on this kind of disease.Through the effective case of Professor Boli ZHANG,who used a small amount of warm and dry traditional Chinese medicine(TCM)and water-inducing TCM,that is,mouth ulcers and palpitations appeared,we will explore the etiology,mechanism,physical characteristics and therapeutic strategy of this kind of disease.This study explores the etiology,pathogenesis,physical characteristics and treatment strategies of“deficiency without tonic”syndrome.This kind of disease mechanism is mostly due to the internal organs of the mixed deficiency and solid,or both cold and heat mixed,air dysfunction,the body is very different and the use of tonic medicine can not be effective,and even the emergence of adverse drug reactions,clinical treatment should be careful to grasp the bias of the drug,a small amount of the beginning of a gradual increase in the amount of attacking and tonic and benefit at the same time and at the same time,treating the symptoms and root causes of the problem,the systematic correction of the bias,moistening and drying appropriate to the use of TCM,there are chapters of the law of the measure.