孔伯华论治神志病经验

Experience of Kong Bohua in Treating Mental Illness

目的:探讨孔伯华论治神志病的学术思想及其用药规律。方法:整理《孔伯华医集·神志病》中的所有病案,对医案中涉及的症状、病性、方药等进行统计分析。结果:医案中涉及的症状有神志失常、失眠、言语失常、烦躁等共24类;病性要素包括气郁、痰湿、热邪和血瘀,共4种;病位主要集中在肝、心、脾等7个脏腑;治则多采用解郁、豁痰、镇肝等共33种;使用的药物有莲子心、旋覆花等共99味。结论:孔伯华认为神志病的主要病机是肝热脾湿、上扰心神;治疗多从肝、心、脾论治,擅于使用镇肝清热、化痰开窍类药物,抓住主要病机,标本兼治,为临床应用中医药治疗神志病及相关疾病提供宝贵经验。

Objective： To explore the academic thought and drug use of Kong Bohua in the treatment of mental illness. Methods： All the medical records in Kong Bohua Medical Collection·Mind Disease were sorted out,and the symptoms,diseases and prescriptions involved in the medical records were statistically analyzed. Results： 24 syndromes such as delirium,insomnia,speech disorder and dysphoria are concerned in the case records,in which the patients mainly showed 4 factors including Qi depression,phlegmatic dampness,heat evil and blood stasis. The diseases were mainly located in 7 organs such as liver,heart and spleen. 33 treatment methods were applied,including dispelling depression,eliminating phlegm,calming the liver,etc. 99 kinds of medicine such as the radical of Lianzixin（ Nelumbo nucifera Gaertn.） and Xuanfuhua（ Inula japonica Thunb）. Conclusion： Professor Kong believes that the main pathogeneses of the disease are liver heat and spleen wet that upset the mind. The treatment is mainly based on the liver,heart and spleen with medicine that,resolves the phlegm and opens one＇s mind,aiming to treat both the syndromes and root causes from the pathogeneses. Such theory provides valuable experience for the clinical practice in treating mind diseases and others with TCM.