马勇教授“血水终始,通利为治”学术思想探讨

Discussion on MA Yong’s Academic Thought of Removing Blood Stasis and Promoting Water Retention

瘀血内阻之机,活血化瘀之法为骨伤科所共识,然追溯《内经》《金匮要略》等,＂血不利则为水＂之理甚为经典,故而存在共识与经典不符的问题。马勇教授研究骨伤疾患数十年,认为前者有违中医整体观念,血既瘀滞,气、津、液亦常紊乱,故从临床和理论角度而言,后者更符合骨伤疾患的病机特点。马勇教授指出,在骨伤疾患中气血瘀阻、营卫不和、气血亏虚三个阶段常有血水互病这一关键病机,故临床上不可局限于活血化瘀之法,而应以灵变处之。

The mechanism of blood stasis and method for activating blood circulation and removing blood stasis are accepted by Department of Orthopaedics and Traumatology,while the traditional Chinese classical book Huangdi Neijing and Jingui Yaolue said： ＂Poor blood circulation will lead to body fluid metabolism disorders ＂,which is quite classic. So,there is a problem between the consensus and the classic. Professor MA Yong who has been working on orthopedic diseases for several decades and thinks that the former viewpoint is inconsistent with the overall concept of traditional Chinese medicine. From the perspective of theory and clinic,the later point that blood stasis may lead to the disoders of Qi,body fluid and water is more consistent with mechanism of orthopedic diseases compared with the former point. Professor MA Yong points out that the key mechanism in three stages（stagnation of Qi and blood stasis,disharmony between Ying and Wei and deficiency of Qi and blood） is metabolism disorder of blood and body fluid in orthopedic diseases. Therefore,in clinical treatment,we can not be limited to the method of promoting blood circulation and removing blood stasis,but should be in the spirit of change.