叶天士通阳散结法辨治胸痹心痛探析

Exploration of YE Tianshi's Tongyang Sanjie in the Treatment of Chest Stuffiness and Pains

胸痹心痛是现代临床上较为多见的病症之一,与现代医学"冠心病"的症状类似。其病因病机多为上焦心阳虚衰、下焦阴寒上乘。本文通过研究《叶氏医衡》、《临证指南医案》、《叶桂医案存真》等著作中有关胸痹心痛的论述及医案,发现叶天士通阳散结治疗胸痹心痛上承仲景之法和历代先贤的研究,注重温通,下启"血络痹痛"与"涌痰法",提出"久痛必入络"、"痛久入血络"以及"涌吐痰涎"等观点,同时兼顾脾胃、寓通于补,注重情志因素,发展了胸痹心痛的病因病机和辨证论治理论。叶氏用药平淡简易但疗效颇佳,其辨治胸痹心痛的思路依然具有指导意义。

Chest pain is one of the most common clinical conditions in modern times.It is similar to the symptoms of modern medical "coronary heart disease".The etiology and pathogenesis of the disease is mostly the ups and downs of the heart and the Yin and the cold.This article explores the discussion of chest pain and heart disease in the works of "YE Medical Balance","Clinical Medicine Case","YE Gui Medical Case",and discovers that YE Tianshi Tongyang Sanjie treatment of chest pain.CHENG Zhongjing's method and the study of the sages of the past dynasties,paying attention to Wentong,starting the "Blood stagnation and pain"and "fever sputum",proposing that "long pain will enter the network","painful into the blood"and "excretion sputum"and other viewpoints,while taking into account the spleen and stomach,through the supplement,focus on emotional factors,the development of the chest and heart pain pathogenesis and syndrome differentiation theory.Yip's medication is simple and simple,but the curative effect is quite good.The idea of distinguishing and treating chest pain is still instructive.