论中医内科疾病五脏分类的临床指导意义

Discussion on clinical significance of five zang viscera classification of diseases in internal medicine of traditional Chinese medicine

目的:探讨《中医内科学》各篇中39种疾病五脏分类的意义。方法:统计39种疾病全部代表方中药物五脏归经的分布,再结合传承工作中老中医用"疾病归经"的临床经验及思路进行整理。结果:心、肝、脾、肺四系疾病归经均以本经为主,如心系疾病代表方中,归心经的药物最多,肝、脾、肺经亦然,分析了肾系疾病出现反常的原因。1中医疾病五脏分类,界定了心肝脾肺四系疾病代表方中多数药物归经。2提出了"疾病归经"和中医诊断,在内科临床上的重要作用。3分辨了临床上的两种归经-疾病归经和辨证分型归经。4阐明了"异病同治"药物归经有别,"同病异治"药物归经一致。结论:中医疾病与治疗药物归经之间有明显的相关关系,为临床选药组方明确了方向。

Objective: To discuss the significance of five zang viscera classification of 39 diseases in Internal Medicine of Traditional Chinese Medicine. Methods: The channel tropisms of drugs in the formulas for treating the 39 diseases were collected and arranged combining with the clinical experience and thinking of veteran doctors of TCM in the inheriting work. Results: The channel tropisms of heart, liver, spleen, and lung diseases give priority to original meridians. For example, the drugs in representative formulas for treating heart disease more belonged to heart meridian, and the meridians of liver, spleen and lung are the same. The cause of abnormal condition in kidney disease was also analyzed. Some results were promoted combined with the thinking of veteran doctors of TCM in disease channel tropisms as follows: 1the five zang viscera classification of TCM diseases has defined the channel tropisms of the most drugs in representative formulas for treating heart, liver, spleen, and lung diseases; 2the important role of ‘disease channel tropisms' and TCM diagnose in clinic was promoted; 3two kinds of channel tropism as disease channel tropisms and syndrome differentiation channel tropisms were distinguished in clinic; 4the distinction among channel tropisms of the same drugs for treating different diseases, and the consistency among channel tropisms of different drugs for treating the same disease were expounded. Conclusion: There is an obvious correlation between the disease of traditional Chinese medicine and the channel tropism of medicine. Defined the direction of choosing medicine and prescription in the clinical.