《金匮要略》痰饮、水气和湿病的辨证论治特色

Characteristics of Differentiation and Treatment of Phlegm,Water Retention and Dampness Diseases ofGolden Chamber

该文归纳和讨论了仲景对痰饮、水气和湿病的辨证论治特点,提出仲景的辨证包括按部位或五脏分型,或以方统证,具有很强的实践性。仲景针对痰饮、水气和湿病的病性、病位和病势提出了"病痰饮者,当以温药和之","诸有水者,腰以下肿,当利小便;腰以上肿,当发汗乃愈"以及"先治新病,病当在后"等治疗原则。文章在阐释痰饮、水气和湿病的病名和三者之间的关系,以及统计所使用的方剂和药物的基础上,还对《金匮》痰饮、水气和湿病的治疗规律进行了探讨,认为仲景对上述疾病的治疗具有提倡异病同治,强调因势利导,注重使用温药和开创利水新法等特点,从而拓宽了临床治疗此类疾病的思路。

The article s and discusses the characteristics of differentiation and treatment on phlegm, water retention and dampness diseases of ZHANG Zhongjing. Zhongjing＇s differentiation is based on the location of the symptoms, organs or formulae and is therefore very practical. ZHANG Zhongjing made suggestions such as transforming phlegm and water retention with warm herbs, treating edema under the waist with diuresis while edema above the waist with diaphoresis, treating acute diseases first and chronic diseases second in accordance with the property, location and status of the diseases. The analysis is based on the explanation of the name and the relationship of the above diseases, combined with the statistics of the herbs and formulae used in Golden Chamber. The article explores Zhongjing＇s laws of treatment on the above diseases, including topics such as treating different diseases with the same principle and formula, treatment of disease according to the tendency and status of the disease, application of warm natured herbs for water metabolism disharmony and removing phlegm and water retention with purgatives. The discussion adds to our perspective on the treatment of such diseases.