史锁芳运用经方治疗肺系疾病经验

Shi Suofang's Experience of Treating Lung Disease with Classical Prescriptions

对于肺系疾病的治疗,史师常遵循"扶正祛邪"之大法:邪盛者,先损其邪气,待邪气稍退,再予以扶正之品,或益气、或补阳、或滋阴,而此多不属于太阳经本证本方之范畴。故不可单纯地攻邪,需要顾及他经而选方用药,认为史师认为:"经方"治疗肺系疾病不仅仅体现在其组方上,更体现在其药物的用量上。虽然有"上焦如羽、非轻不举"之说,但当病情复杂、缠绵不愈时,加大药物剂量反而有药至病退之效,力求以本草之偏性纠人体之偏来达到治愈疾病的目的。史师在准确辨证的基础上来合理选方用药。只有在"是证"的情况下,才可能出现"是症",而抓住"是症",即可合理地选方用药。在临证用药中,常围绕"能否纳谷""纳谷多少"来判断是攻是补、是峻是缓。如脾不健运或纳谷不馨者,史师常选用枳术汤或薯蓣丸加减;如兼见中焦痰湿较盛者,常合香砂六君子汤或二陈汤加减;"中焦以运为健",补益之剂佐以健运消导之品则对于中焦脾胃更是合拍。史师认为,只有中焦健运才可受峻药、御外邪。

For the treatment of lung disease,Doctor Shi usually follows the principle of ＂ strengthening healthy qi to eliminate pathogenic qi＂. For patients with excessive pathogenic qi,tonics were usually administered after eliminating some pathogenic qi,including qi tonics,yang tonics or yin tonics; but this does not belong to the category of the prescriptions and syndrome of Taiyang stage. Avoid merely eliminating pathogen and other meridians should also be taken into consideration during the selection of prescription and herbs. According to Doctor Shi,the features of ＂ classical prescription＂ in treating lung disease not only manifests on the composition of the formula but also the dosage of the herbs. Despite of the theory ＂ when treating disease of the upper energizer,only feature-like light dosage of herbs can be used＂,increase in the dosage may have instant effect for the abatement of disease when the disease condition is complex and lingering. Doctor Shi combines accurate syndrome differentiation with reasonable selection of prescription and herbs. Symptom arises from relevant syndrome,and by focusing on the exact symptoms reasonable selection of prescription and herbs can be ensured. In clinical drug use,the application of purgatives or tonics,with drastic property or moderate property is determined by ＂ the ability of receiving food and the amount of food that can be received＂. For dysfunction of transportation and transformation of the spleen and stomach,he often selects Zhizhu Decoction or modified Shuyu Pill. For excessive phlegm-dampness in the middle energizer,Xiangsha Liujunzi Decoction or modified Erchen Decoction is often added.Smooth transportation is essential for healthy middle energizer,so digestion-promoting herbs added to the tonics will be better for the spleen and stomach of the middle energizer. He holds that only transportation-effective middle energizer can tolerate drastic herbs and defend external pathogens.