曲直濑道三临床学术特点探讨

Analysis on Manase Dōson's Clinical Academic Characteristics

从日本汉方历史发展的角度,运用文献分析、综合对比、典型案例剖析等研究方法 ,概括了日本汉方医学后世派代表性医家曲直濑道三的个人生平,分析了《启迪集》《出证配剂》《云阵夜话》《针灸集要》等其临床代表著作,将曲直濑道三临床以阴阳五行学说为框架,擅长灵活运用经验药方,一贯运用"察证辨治"等学术特点,总结为临机应变、倡导察证辨治,医出正宗、强调经典理论,崇尚朱丹溪、重视气血痰,以及简素方便重视实用性四方面,并分析了曲直濑道三治疗伤寒四日少阳病、肺阴虚咳嗽和肝血虚肝气郁不妊的三个病案,进一步阐释其诊疗思维特色,以期为现今中医学临床实践和传承创新提供借鉴和启示。

From the perspective of historical development of Japanese Kampo,this paper summarized Quzhi Laidaosan ＇s（Manase Dōson ＇s） personal life,a representative practitioner in Gosei-ha school of Japanese Kampo medicine,analyzed the classical works including Qi Di Ji（Keiteki Shu）,Chu Zheng Pei Ji（Corresponding Formula Based on Pattern）,Yun Zhen Ye Hua（Night Talks at Yunzhen）,and Zhen Jiu Ji Yao（Collections of Acupuncture and Moxibustion）,and clearly elaborated his ideas that he set Yin-yang theory and five phase theory as frames. He was expert in using empirical prescriptions and insisted on pattern observation and treatment into four clinical academic features for the first time by literature analysis,comprehensive comparison and discussion on typical cases. The four features were flexibility and advocation of pattern observation and treatment in clinic,origination from authentic school and stress on classical theory,adoration of Zhu Danxi and emphasis of Qi,blood,and phlegm,simplicity,convenience and practicability.Three medical cases including lesser Yang disease contracted by cold pathogen in the fourth day,cough in lung-yin deficiency,and infertility due to Qi depression and blood deficiency of the liver treated by Manase Dōsan were analyzed aiming at restoring his way of thinking in diagnosis and treatment and real situation based on practice and currently providing a reference and inspiration for clinical practice,inheritance and innovation in traditional Chinese medicine.