再从湿疹病案谈运气司天方的临床应用

Further discussion on Yunqi Sitian Fang's clinical application on cases of eczema

为进一步理解运气理论"必先岁气,毋伐天和"和"顺天以察运,因变以求气",将两则湿疹案例先后同病异治的诊治经过记录于文,附加个人浅薄心得,以期抛砖引玉,通过讨论,加深对三因司天方临床应用的认识。三因司天方黄连茯苓汤治以寒凉立方,所谓寒盛火郁之会也;升明汤,是岁上为相火,下属风木。正民病火淫风胜之会也。同治湿疹,即使同人同病,运气变化,病机变化,治法不同,方可有效。运气学说是中医学整体观念的集中体现,充分考虑了天、地、人合一的思想。把握运气变化,抓住疾病的先机,方可提升临床思维。

To further understand the qi circuit theories of ‘always considering yearly qi circuit first and never against natural harmony’ and ‘complying with the nature to observe the qi circuit and seeking genuine qi circuit in changes’, different treatment courses of two identical eczema cases occurred in different times were recorded and personal thoughts were put forward for further discussion, thus deepening people’s understanding of Sanyin Sitian Fang’s clinical application. Sanyin Sitian Fang’s Huanglian Fuling Decoction is established by its cold and cool nature, aiming to clear heat constraint, while Shengming Decoction is designed for ministerial fire in the year with excessive wind. Even if the same person is afflicted by the same eczema, the treatment could only be effective by altering according to changes of qi circuit and disease mechanism. The theory of qi circuit is a key reflection holism in Chinese medicine, which takes the correspondence of heaven, earth and people into full consideration. Doctors can improve clinical thoughts by understanding changes of qi circuit and grasping the start of diseases. If Yunqi Sitian Fang can be applied flexibly, favorable clinical effects could be achieved.