连建伟教授对右关脉虚大的脉理探析及诊治

Analysis on the Pulse Mechanism,Diagnosis and Treatment of Pro. Lian Jianwei for the Right Guan Large Virtual Pulse

[目的]研究连建伟教授关于右关脉虚大的诊治。[方法]透过分析连教授学脉过程及其日常门诊病例,探索连教授临证对右关脉虚大的诊治,总结连教授右关脉虚大的脉理及其选方用药。[结果]连教授重视东垣注重脾胃的学术思想,且精于脉诊,认为右关脉虚大为右手关脉出现脉体宽大,按之空豁之象。主要因饮食劳倦及思虑过度,导致脾胃气虚,阴火内生,灼伤阴血,使气不能附于血而上浮于卫表。对此的治疗当遵《内经》"劳者温之"之训,以东垣甘温之补中益气汤补气升阳,使元气足而阴火敛,并随病人证情而加减化裁。[结论]连教授善于继承东垣脾胃学说,临证注重脉诊,善于运用东垣补中益气汤加减化裁治疗右关脉虚大之证。

[Objective] Research for the pulse mechanism, diagnosis and treatment of Pro. Lian Jianwei on right guan large virtual pulse. [Method] Through analyzing Pro. Lian learning process of pulses and his outpatient cases, explore his clinical diagnosis and treatment on right guan large virtual pulse, summarize the right guan large virtual pulse mechanism and the use of formula and medication by Pro. Lian. [Result] Pro. Lian attaches importance to the value of Li Dongyuan’s academy of spleen and stomach, skil in pulse diagnosis. He considers that right guan large virtual pulse is the pulse on right hand guan which is wide and large, soft and empty when taking pulse. Internal injury due to emotional disorder and diet fatigue are the main factors that result to deficiency of spleen qi and stomach qi, endophytic of yin-fire, consumed yin-blood, causing qi detached from blood and lead to the rising of qi to surface. The treatment obeys the rules of“debilitated patients treated with herbs warm in property ”by“Neijing”, uses Li Dongyuan’s Buzhongyiqi decoction with herbs sweet in flavor and warm in property to invigorate qi to elevate spleen-yang, for sufficient primordial qi and convergence yin-fire, also modifying the formula accord-ing to the patient’s syndrome. [Conclusion] Pro. Lian is good at inheriting Li Dongyuan’s spleen and stomach academy, attaches importance to the pulse diag-nosis in his clinical practice, good at using Li Dongyuan’s Buzhongyiqi decoction and modifying it according to the patient’s syndrome as the treatment for right guan large virtual pulse.