韩臣子“调中焦-清源流”“通-调”辨治石淋

HAN Chenzi(韩臣子) "Tiaozhongjiao-Qingyuanliu" and "Tong-Tiao" to Distinguish Stone from Drench

韩臣子认为泌尿系结石形成本源为脾胃运化失司,肾结石归"腰痛",输尿管结石归"石淋",脾胃失和是结石源头,治疗应从源头论治,重视"调中焦,清源流",突出"通"与"调",配合清热、利湿、化瘀、调气、疏肝、益肾等,以调中焦为基本,预防结石,结合体质,健运脾肾,保护胃气,复其升降,调其气血,使中枢运化和谐,结石无源以生。急性活动期重在"通",通血脉,畅气机,缓急止痛;静止缓解期重在"调",调中焦,调整脏腑阴阳平衡,调理中焦脏腑功能,恢复升降出入,清结石形成之源,减少结石生成。常在利尿通淋排石药物中加山萸肉、黄芪、白术炒等健脾肾,助气化。治疗石淋韩师特色用药是鱼枕骨,取其沉降溶石通淋,促进结石排出;结石急性发作常引起胃肠道反应,实证为主,腹满燥实,宜及时泻下通便,承气汤类加减,韩师常用芒硝,一则泻下通便,清除胃肠积滞,二则取其软坚化石之能。韩师认为血尿多为结石阻塞或结石下移,血脉瘀阻,血络破损,血溢脉外,乃离经之血,宜化瘀止血,用小蓟、蒲黄、三七粉、川芎、当归、红花等活血凉血止血,亦是调畅气血,以通为用。临证不局限于所患之病,着眼调整脏腑阴阳,恢复气机升降出入,强调脾胃通调对防治疾病的重要意义,始终注意顾护脾胃,保养胃气,防止苦寒清利药物过多,伤伐正气。附石淋(输尿管结石)验案1则。

HAN Chenzi believes that the origin of urinary calculi is the loss of spleen and stomach,kidney calculi is the "back pain",ureteral calculi is the "stone shower",spleen and stomach are the source of calculi.Treatment should be based on the source,pay attention to "Tiaozhongjiao,Qingyuanliu",highlight "Tong" and "Tiao",cooperate with clearing heat,diuresis,removing blood stasis,regulating Qi and soothing liver.In order to prevent stones,we should focus on the central nervous system,prevent stones,combine physical fitness,invigorate spleen and kidney,protect stomach Qi,restore its rise and fall,regulate its Qi and blood,make the central transportation harmonious,and make the stones live passively.Acute active period focuses on "Tongxue",Tongxue,Qichang,relieving pain;static remission period focuses on "tuning",focusing,adjusting the balance of Yin and Yang of viscera,regulating the function of viscera,restoring ascending and descending entry,clearing the source of stone formation,and reducing stone formation.The spleen and kidney are often added in the medicine of diuresis and drenching stone,such as Cornus officinalis,astragalus root and stir frying atractylodes rhizome.Shilin’s characteristic medication is fish occipital bone,sedimentation and dissolution of stones to promote stone discharge;acute onset of stones often causes gastrointestinal reactions,evidencebased,full and dry abdomen,it is appropriate to timely diarrhea and defecation,Chengqi decoction type added or subtracted,Han Shi often uses mirabilite,one diarrhea and defecation,remove gastrointestinal stagnation,the other takes its soft and hard fossil energy.HAN Shi believes that hematuria is mostly caused by stone obstruction or stone downward movement,blood stasis,blood collateral damage,blood overflow outside the vein,which is deviated from the meridian.It is advisable to remove blood stasis and stop bleeding.It is also used to regulate Qi and blood circulation by promoting blood circulation and cooling blood such as thistle,cattail,Panax notoginseng powder,chuanxiong,angelica sinensis and safflower.Clinic syndrome is not limited to the disease,focusing on adjusting the viscera Yin and Yang,restoring the air machine to rise and fall,emphasizing the importance of regulating spleen and stomach to prevent and cure diseases,always paying attention to protecting spleen and stomach,maintaining stomach Qi,preventing the excessive use of bitter cold,clearingaway dirty drugs and damaging vital energy.There were 1 cases of stone attached(ureteral calculi).