基于《临证指南医案》和《不居集》探析叶天士与吴澄脾胃阴虚理论之异同

Exploring the differences and similarities between Ye Tianshi and Wu Cheng's theories of fispleen and stomach yin deficiency based on their medical works

叶天士与吴澄继承并发展了李东垣的脾胃学说。叶天士提出“胃阴虚”“脾胃分治”等理论;吴澄在新安派虚劳理论指导下,形成“脾阴虚”理论思想。叶天士和吴澄都重视脾阴对胃阴的影响,两者在脾胃理论上相辅相成,补充了脾胃学说中只补脾阳之不足,对脾胃论治具有重要的学术价值。本文基于《临证指南医案》和《不居集》分析脾胃阴虚的生理病理特点、脾胃与五脏之间的联系,探讨叶天士和吴澄对脾胃阴虚的治疗规律和用药特色及异同。

Ye Tianshi and Wu Cheng inherit and develop Li Dongyuan's theory of spleen and stomach,as Ye Tianshi proposes theories such as"deficiency of stomach yin"and"spleen and stomach diseases being treated separately",while Wu Cheng develops his unique theory of"spleen yin deficiency"under the guidance of Xin'an school's theory of consumptive diseases.In their theories,both Ye Tianshi and Wu Cheng attach great importance to the influence of spleen yin on stomach yin,and their theories complement each other in the theory of spleen and stomach,overcoming the weakness of only invigorating spleen yang in previous spleen and stomach theories,having an extremely important academic value for the separate treatment of spleen and stomach diseases.Based on A Guide to Clinical Practice with Medical Records and Buju Ji,this article analyzes the physiological and pathological characteristics of spleen and stomach yin,as well as the relationship between the spleen and stomach and the five-zang viscera,exploring their treatment rules,medication characteristics,and similarities and differences in treating diseases with the syndromes of spleen and stomach yin deficiency.