阮怀清噫嗳反胃治法经验举要

Enumeration of RUAN Huaiqing's Clinical Experience in Treating Ructation and Regurgitation

[目的]探析近代浙东名医阮怀清在噫嗳反胃等病症的治法经验,以期对现代临床诊治此类疾病有所启发。[方法]通过对阮怀清著作《阮氏医案》的阅读和研究,以及对其中噫嗳反胃有关医案的整理归类和深入解析,提炼其诊治噫嗳反胃的临床经验。[结果]阮氏诊治噫嗳、呕恶、吐酸、嘈杂等病症,重视情志致病因素,治以开郁通降之法,喜用丹溪越鞠丸和仲景旋覆代赭汤。具体临证,结合因机,或开郁疏湿,或和胃降逆,或扶土抑木,或温运通降。诊治反胃、噎膈等脾胃病中病情较重者,对其病机判断和治法处方很有见解。正治之法,以和胃为主;治之变法,以补肾为要。[结论]阮氏诊治噫嗳反胃等病症,医理治法清晰明了,处方用药自出机杼,对现代临床相关疾病的诊治有着重要的指导作用。

[Objective]The paper discussed and analyzed the clinical experience of eastern Zhejiang＇s modern famous doctor RUAN Huaiqing in ructation and regurgitation in order to inspire diagnosing and treating the disease nowadays. [Method]The paper refined the clinical experience of RUAN ＇s in diagnosing and treating ructation and regurgitation by reading and researching RUAN＇s related work Ruanshi Yi＇an and classifying and analyzing his medical record in depth. [Result]When RUAN＇s diagnosed and treated ructation, vomiting, acid regurgitation and gastric discomfort, he thought highly of emotional factors,treated it by expelling stagnation and descending and unobstruction, and liked using ZHU Danxi ＇s Yueju pill and ZHANG Zhongjing＇s Xuanfu Daizhe decoction. Specific clinical experience combined with etiology and pathogenesis could be expelling stagnation and sparsing wet, harmonizing stomach for descending adverse Qi, supporting soil and restraining wood, or warming for descending and unobstruction. When he diagnosed and treated regurgitation and cardiac spasm which were critical illness in spleen and stomach disease, he had his own opinion on judging pathogenesis and therapy. Routine treatment was harmonizing stomach, and unconventional treatment was tonifying kidney. [Conclusion]RUAN＇s medical knowledge and therapeutic method were very clear,and prescriptions stroke out a new path for himself. All these things could guide diagnosing and treating ructation and regurgitation nowadays.