近代医家邵兰荪儿科病诊治经验探微

Analysis of SHAO Lansun‘s Experience in Diagnosis and Treatment of Pediatric Diseases

[目的]探析近代临床医家邵兰荪儿科病诊治经验。[方法]通过研读曹炳章之《邵兰荪医案》、裘吉生之《邵氏医案》、周毅修之《周辑邵氏医案评议》、潘国贤之《邵兰荪累验医案》,共收集整理儿科病相关医案60余则,结合叶天士、万全等医家对于儿科病的观点,从临床诊断、主治病症、临证治法、治疗原则、用药特色等方面,总结邵兰荪治疗儿科病的经验。[结果]邵兰荪治疗儿科病,临床诊断首重望诊,而察色望形之中,尤善察“三关”、审“山根”,并四诊合参。因小儿纯阳之体,疾病多从火化,故其诊治以热病为主。在热病中,邵兰荪受万全“肝常有余,脾常不足”理论的影响,脏腑辨证多从肝脾论治;结合绍兴地处江南,气候温暖湿润的特点,认为热病多兼挟湿,故治疗疾病善于淡渗分利。邵兰荪遵循未病先防的原则,对于小儿稚阴稚阳之体,多防病于未起,注重顾护胃气。由于温热病邪易伤津耗液,处方用药喜施鲜药,鲜药多清灵之性,清热而不伤津,以期轻可去实。[结论]邵兰荪治疗儿科病,医理治法清晰明了,处方用药经验独到,深入研究其儿科病诊治经验,对于指导临床上儿科病的治疗具有重要参考价值,有助于提高此类儿科疾病的临床诊治水平。

[Objective] To discuss and analyze SHAO Lansun's experience of diagnosis and treatment in pediatric diseases. [Methods] Through reading and studying CAO Bingzhang's SHAO Lansun's Medical Cases, QIU Jisheng's SHAO's Medical Cases, ZHOU Yixiu's SHAO's Medical Records Edited by ZHOU Yixiu, PAN Guoxian's SHAO‘s Proven Medical Records, more than 60 cases related to pediatric diseases were collected and sorted out. Combined with the views of doctors such as YE Tianshi and WAN Quan on pediatric diseases, SHAO Lansun‘s experience in the treatment of pediatric diseases was summarized from the aspects of clinical diagnosis, main indications, clinical treatment, treatment principles and characteristics of medication. [Results] When SHAO Lansun treated pediatric diseases, he prioritized inspection, especially to check the “San Guan”, review the “Shan Gen”, and combined four diagnosis integration. Because of the pure Yang's body in children, many diseases turned out to be caused by pathogenic fire, so febrile disease was the main disease diagnosed and treated. In febrile disease, SHAO Lansun was influenced by the theory of “liver was always surplus and spleen was always deficient” put forward by WAN Quan, the treatment was mostly from the liver and spleen by viscera syndrome differentiation. Considering that Shaoxing is located in the south of the Yangtze River and has a warm and humid climate, it is considered that febrile diseases are often accompanied by dampness, so the treatment of disease is skilled at diuresis-removing dampness. SHAO Lansun followed the principle of prevention before disease, for the immature Yin and immature Yang in children's body, preventing disease before it appeared, and paying attention to care for gastric Qi. Because the warm pathogenic factors easily impaired and depleted fluid, he liked to prescribe fresh drugs that were mild and could clear the heat without damaging the fluid, and believed that light drug can remove excess evil. [Conclusion] The experience of SHAO Lansun in treatment of pediatric diseases is clear and precise, and his prescription experience is unique. In-depth study of the experience in the diagnosis and treatment of pediatric diseases has important reference value for clinical guidance and is helpful to improve the level of clinical diagnosis and treatment of such pediatric diseases.