丁济万治疗湿温病临证经验浅析

Research and Analysis on Ding Ji-Wan's Clinical Experience in Dampness Prevalent Diseases Treatment

[目的]介绍丁济万治疗湿温病的临床经验。[方法]分析丁济万临床上根据湿温病的不同阶段,采用六经和卫气营血合而辨证的方法,并附少量医案说明丁氏辨证细腻、用药轻灵的特色。[结果]湿温之证,在温病中比较特殊,温是阳邪,湿是阴邪,湿与温合,或从阳化热,或从阴化寒,所以要根据湿温的变化或从伤寒辨证,或从温病辨证:邪在卫、气,按三阳经治法;湿胜阳微,按三阴经治法;邪热从阳入阴,按温病热传营血治法。其次,湿温主要病变部位在中焦脾胃,三焦的症状无不与脾胃病变有关,所以要兼顾中焦,配以化湿健脾之法。[结论]湿温病是湿热之邪侵袭人体所导致的以脾胃为病变中心的一类疾病。丁氏一派本着"辨病机,有是证,用是方"的原则,广泛而灵活地运用六经体系及卫气营血辨证,大大丰富了湿温病的治疗方法。

[Objective] The article introduces Ding Ji-Wan＇s clinical experience in dampness prevalent diseases treatment. [Method] The article analyzes the different stages of the disease in Ding Ji-Wan＇s clinical treatment, by combining six meridians and Wei-Qi-Ying-Xue differentiation, attaching a few clinical cases to illustrate Ding＇s light and simplified treatment style. [Result] The seasonal prevalent disease is special in febrile diseases, warm disease belongs to Yang evil, dampness, Yin evil; dampness together with warmness changes to Yang heat or to Yin coldness, so to make differentiation from damp-warm changes or from warm disease： if the pathogeny is in Wei and Qi, treat with 3 Yang meridians; if the dampness excesses Yang, treat with 3Yin meridians; if the pathogeny heat enters Yin from Yang, treat under warm disease heat transferring to Ying blood. Next, damp warm disease mainly exists in middle spleen and stomach, tri-jiao symptoms all are related with spleen and stomach diseases, so we shall pay attention to middle-jiao,coordinated with method of removing dampness to benefit spleen. [Conclusion] The damp and warm disease is a kind of disease centered on splenicgastric lesion induced by damp heat invading body. Ding＇s upholds the principle：＂differentiating mechanism, applying formulae to corresponding signs ＂,broadly and neatly making differentiation of 6 channels system and Wei, Qi, Ying and blood, greatly richening treatments to damp warm disease.