《临证指南医案》肠痹浅析

Analysis of Large Intestine Stagnation from Ye's Book—A Guide to Clinical Practice with Medical Records

《临证指南医案》肠痹一门所载8则医案,反映了叶氏诊疗肠痹的经验。本文通过对叶氏肠痹医案所载症状及评按的分析,医案间用药的对比,并结合诸家经验,总结出叶氏诊疗肠痹以肺失宣降,腑气不通为主要病机;以辛润宣上通下法为主要治法;以辛苦、甘苦之味,诸如杏仁、瓜蒌皮、郁金、豆豉组成基础方剂,随症增减以治疗肠痹的独特经验。旨在阐释肠痹其病及其治法,为临床治疗大便不通提供参考。

＂Ye＇s Book--A Guide to Clinical Practice with Medical Records＂ included 8 case records, which showed the YE Tian-shi＇s treating experience in large intestine paralysis. This paper aims to analyze the 8 case records to summarize main pathogenesis, treating method and medicine combination according to the clinical symptoms as described, comparison between the medical treatments. At last, the main pathogenesis of large intestine stagnation is purifying and descending of lung Qi, which leads to Fu Qi obstruction ; the main treating methods is purgating by purifying and deseendingof lung Qi. Meanwhile, the medicine combination is almond, trichosanthes peel, Turmeric, and Fermented soya bean. The summaries of YeTianshi＇ s treating experience of large intestine stagnation provide the reference for the clinical treatment of constipation.