叶天士治疗胃脘痛学术思想探析

Discussion on the Academic Thought of Ye Tianshi in Treating Epigastric Pain

清代医家叶天士认为脾属己土,脾宜升则健,脾主运化;胃属戊土,胃宜降则和,胃主纳。脾胃共同完成水谷的消化、传输,但各有特点,临证当分而治之。通过反复研读《临证指南医案》中胃脘痛篇,可归纳出其治疗胃脘痛的学术思想:治胃先治肝、治分气血、久病入络、温通胃阳、顾护胃阴、肝风内中等,在临床工作中,有很大的指导价值。

Objective Physician Ye Tianshi of Qing Dynasty believes that the spleen belongs to Ji-earth, spleen is strong when ascending, and spleen is in charge of transportation. The stomach belongs to Wu-earth, stomach is comfortable when ascending, and stomach receives food and drink. The spleen and stomach complete digestion and transmission of food and water, and each has its characteristics. In clinical practice, they should be treated differently. Through repeatedly reading the chapter of stomach pain of Guide to Clinical Practice with Medical Records, it can be concluded that the academic thought of treating stomach pain as follows： the liver should be treated firstly when treating stomach, differentiation of breath power and blood, chronic illness invading collaterals, warmly dredging stomach yang, nursing stomach yin and endogenous wind. In clinical work, the academic thought has great guiding value.