吴寿善治疗燥证学术思想与临证经验总结

Summary of Wu Shoushan's Academic Idea and Clinical Experience in the Treatment of Dryness Syndrome

吴寿善教授对"燥气大纲"有独到见解,不仅提出了有凉燥、温燥伤人、燥化寒湿、湿热伤人,并且提出燥气有"胜复"不同:化热伤津之证属燥之复气伤人,寒湿之证是燥之胜气伤人。因此,可见《温病条辨》中所列杏苏散等方,正是为治燥之胜气、治燥之正化、治燥之本病而设。所列的桑杏汤等方则是为治燥之复病、治燥之对化、治燥之标病而设,从而使燥气之本标胜复病机霍然。吴教授还强调见化气为病有寒热之别,见寒湿者自当用温化,见湿热者自当用清泄。临证时还须注意表里寒热之不一,只有这样才能达到技药愈病之目的。燥伤本脏除识别复气现症外,还要选药精当。笔者在临床上发现,凡见杏苏散证而有痰黏、频咳、唾出不爽者,视其轻重而选加冬瓜仁、贝母、鱼腥草、半枝莲等品,以清复热,效果较好,若见小青龙汤证而兼复气为患者,追加药物亦可仿此。

Professor Wu Shoushan has original ideas on ＂ key points of dryness pathogen＂. He not only proposes that cold dryness and warm dryness could impair the human body,dryness transforms into cold dampness and damp heat impairs human body,but also believes that dryness pathogen has difference between preponderance qi and revenge qi： syndrome of transforming heat and impairing body fluid pertains to the preponderance qi impairing the body while syndrome of cold dampness pertains to the preponderance qi of dryness impairing body. Therefore,in Systematic Differentiation of Warm Diseases,there is Apricot Kernel and Perilla Powder which is for the preponderance qi of dryness and root cause of the disease,Mulberry Leaf and Apricot Kernel Decoction for disease due to revenge qi of dryness and the superficial manifestations. Professor Wu stresses the difference between cold and heat in diseases resulting from qi transformation. Cold dampness should be treated by warming,damp heat should be treated by clearing and purging. In clinical practice,exterior,interior,cold and heat should be differentiated,thus the objective of curing disease can be achieved. In dryness impairing viscera,the present symptoms due to revenge qi should be identified and the drugs should be selected correctly and precisely. It is found that for the syndrome of Apricot Kernel and Perilla Powder accompanied with frequent cough,stick phlegm difficult to expectorate,Dongguaren（ Semen Benincasae）,Beimu（ Bulbus Fritillaria）,Yuxingcao（ Herba Houttuyniae） and Banzhilian（ Herba Scutellariae Barbatae） can be properly added to clear heat cause by revenge qi; for syndrome of Minor Green Dragon Decoction complicated with symptom due to revenge qi,drugs can also be modified.