以湿温理论指导痰湿证的治疗

Guide of the Phlegm-dampness syndrome by the Warm-damp theory

湿与痰在病机和病证上有共通性。病机上,湿与痰俱为津液代谢异常产物,其性重浊黏滞,易于阻遏气机,损伤阳气;病证上,二者俱属阴邪,随气升降,流布全身,致病广泛。湿痰常交互为患,病位主要在肺脾肾,分属三焦。笔者将温病学派辨治湿温的丰富理论引申转化用于痰湿证的治疗,提出治痰亦需分三焦,痰湿在上焦宜开泄肺气涤痰,在中焦宜健运脾气而祛痰,在下焦则应温肾气、助气化而化痰的观点,兹详述如下。

Pathogenic dampness and phlegm have the same character on the aspects of pathogenesis and disease syndrome. Pathologically, they both result from the disturbance of body fluid or the improper diet. Dampness is heavy and turbid, which tending to block qi. On syndrome and symptom, they both belong to yin, move around the body with qi and attack widly and reciprocally, especially focusing on the lung, spleen, kidney and Sanjiao. Based on the above, we consider that the treatment of dampness and phlegm have the same identity, After summarizing the rich experiences on treating damp warm syndrome of the warm diseases school, we transform it into the treating of phlegm-dampness, put forward some views and opinions about differentiation of SanJiao, which means dispersing lung qi to flush phlegm if in upper-jiao, activating spleen to remove phlegm if in middle-jiao, warming the kidney to active the function of qi to reduce phlegm if in lower-jiao. Described in detail in the following.