古病奔豚源流探析

Tracing Origin of Ancient Disease “Bentun”

通过查阅《黄帝内经》《难经》《金匮要略》《脉经》《肘后备急方》《诸病源候论》和《备急千金翼方》等古代中医学典籍中奔豚病的相关记载发现,奔豚病名是以临床症状命名,其发病部位可在少腹、心胸、肚脐周围,可涉及肾、心、肺、肝、脾、胃等脏器。奔豚的病因可由寒邪、忧思、抑郁、惊恐等不良情志刺激造成,或由失治、误治,或因治疗后处理不当所致。其病机以肾阳不足,寒邪侵袭,循经而入,寒邪留于少腹日久不散,惊恐忧思抑郁使气机升降失常而成奔豚。其证候表现,在少腹或脐间、或心胸,有气拱动走窜不定,或伴有喘咳逆气,心悸不安,呕逆,腰膝酸软下肢痿弱屈伸无力,二便不通等。对于奔豚的治疗,古医籍中有针刺、内服方药及灸法,在治疗过程中常内外合治,并注意治疗禁忌。用药多以扶正祛邪,理气和中,调胃理脾,培补元气,温阳散寒,平降冲逆之气为主。此病病程长,易反复发作,令患者痛苦不堪,但不危机生命,可带疾延年。文章从源流进行梳理,以阐释其临床诊疗价值,为指导临床治疗胸腹腔疾病提供参考。有助于中医理论的传承和创新。

By reviewing the discussion of Bentun disease in Huangdi Neijing,Nanjing,Jingui Yaolue,Maijing,Zhouhou Beijifang,Zhubing Yuanhou Lun,Qianjin Yifang and other classical Chinese medicine books,we understand that Bentun disease is named according to its clinical symptoms.The disease site can be in the abdomen,chest or around the navel,and it involves kidneys,heart,lungs,liver,spleen,stomach and other organs.Bentun disease can be caused by bad emotional stimuli such as cold,worry,depression,panic,etc.,or due to lack of treatment,incorrect treatment,or improper care after treatment.Its pathogenesis is insufficiency of kidney-Yang,which causes cold-pathogen invading into the body along the route of human meridians and remained in the abdomen for a long time,or its pathogenesis can be Qi activity disorder caused by worry,depression and panic.Its clinical symptoms are manifested by Qi moving around and fluctuating in abdomen or umbilicus,or in chest,sometimes accompanied by cough and asthma,hiccup,palpitation,upset,nausea,or soreness and weakness of waist and knees,weak wilting lower limbs,weak flexion and extension,anuria and constipation,etc.For the treatment of Bentun disease,there are acupuncture,oral medicine and moxibustion methods according to these books.During the treatment process,internal and external treatment are often combined,and it is necessary to pay attention to the treatment contraindications.The basis of medication is mostly based on strengthening the body resistance to eliminate pathogenic factors,regulating Qi-flowing for strengthening spleen,complementing the vigour,warming Yang for dispelling cold,and depressing Qi.Bentun disease has a long disease course and is prone to recurrent episodes,which would bring suffers to patients.But it would not be life-threatening and patients can survive with illness.We traced Bentun disease from its origin in this article to explain its clinical value and provide a reference for guiding the clinical treatment of various diseases of the chest and abdomen.This research contributes to the inheritance and innovation of traditional Chinese medicine theory.