基于“以温药和之”理论探讨痰饮病治疗

Discussion on phlegm-retention disease based on“treating phlegm-retention with warm herbs”

痰饮,是脏腑气化功能失常,水液代谢输布失司形成的病理产物,张仲景于《金匮要略·痰饮咳嗽病脉证病治篇》中提出“病痰饮者,当以温药和之”,成为后世医家治疗痰饮病的总则。本篇通过分析痰饮病机,阐述“温药和之”经义的精髓,梳理出了痰饮病治疗思路,概括为“温阳助运,扶正培元”“温化宣通,疏调气机”“燮理阴阳,和之平衡”三方面,以期为现代临床痰饮病论治提供参考。

Phlegm-retention is the pathological product of the function disorder of the viscera qi and the metabolism of water and liquid.In the Synopsis of Prescriptions of the Golden Chamber,ZHANG Zhong-jing put forward that“those who are sick with phlegm should use warm herbs to moderate it”,which becomes the general principle of treating phlegm-retention syndrome for later generations of doctors.Through analyzing the pathogenesis of phlegm-retention,this paper expounded the essence and meaning of“treating phlegm-retention with warm herbs”,and combed out three targeted therapeutic approaches,namely“to regulate qi by promoting warmth and circulation”,“to strengthen body through boosting yang”,“to balance yin and yang through management”,hoping to provide reference for modern clinical treatment of phlegm-retention diseases.