浅析陈士铎辨治“中满”的思路与特色

Thoughts and characteristics of CHEN Shi-duo on syndrome differentiation of center fullness

陈士铎为清代著名医家,在其所著《辨证录》中专设有"中满门"一节。他认为"中满"病在脘腹,其病机之关键是脾气之衰,但不宜忽视脏腑气机之间的相互影响;在治疗上强调重在实脾,但要结合阴阳消长、五行生克规律,以及脏腑相关理论指导施治。陈士铎的论述是通过对四则具体病案诊治过程的分析,从而阐述辨治"中满"的思路与方法。并且结合病案自拟代表方温土汤、快膈汤、抒胀汤、生胃进食汤、调饥散、熏脾汤,其用药平和,辨证明确。其对辨治中满的思路,对提高中医师承临证学习具有一定的指导意义。

There is a section of ‘Class of center fullness' in book Collecting Record of Differentiation of Symptoms and Signs written by CHEN Shi-duo,a famous physician in the Qing dynasty.He believes that the disease of center fullness is located in the stomach,and the key pathogenesis is the decline of spleen qi,but the mutual effect among qi function of Zang and Fu should be paid attention.In the treatment,it is emphasizedon reinforcing the spleen in combination with the rule of yin and yang,the five elements,and the guidance of the relevant theories of the Zang and Fu.By analysis on diagnosis and treatment of CHEN's four cases,the thoughts and methods of center fullness were expounded.In the end,the cases were combined with the formulae including Wentu Decoction,Kuaige Decoction,Shuzhang Decoction,Shengwei Jinshi Decoction,Tiaoji Powder,Xunpi Decoction,in which the medicines are peaceful,and the syndrome differentiation is clear.The thinking of syndrome differentiation on center fullness has a certain guiding significance for clinical study.