叶天士从络病理论辨治胃脘痛思路探析

Study on YE Tianshi's Academic Thinking of Using Collaterals Theory to Cure Epigastric Pain

清代名医叶天士善于从络病理论辨治胃脘痛。他认为胃脘痛的络病辨证总以区分虚实为要,通络治法亦根据脏腑辨证结果、病情轻重、病程长短灵活变通:病邪入络浅,络病轻者,以辛香通络为常法;入络深,瘀阻明显者,以化瘀通络为主;若胃脘痛病久、病重,络中痰凝、瘀浊不去,常药难以奏效,则以虫蚁搜络之法治之。络脉虚损者以补虚通络为治疗原则。此外,顾护胃气贯穿通络治法之始终。

YE Tianshi was a famous doctor in Qing dynasty. He was good at using collaterals theory to cure epigastric pain.He emphasized the syndrome differentiation about epigastric pain should differentiate collaterals＇ deficiency and excess. His therapies to dredging collateral vessels were also based on the results of syndrome differentiation,state of an illness and the curse of epigastric pain. If the pathogenic factors were in the surface of the collateral vessels and the state of an illness was slight,he usually used spicy drug to cure epigastric pain. If the pathogenic factors were deep in the collateral vessels,he used the treatment of dispersing blood stasis and dredge collateral to cure epigastric pain. If the epigastric pain was severe and lasting long,he used parasitic drug to cure it. If the collateral vessels were insufficiency,he tonified deficiency of the collateral vessels with dredging collateral vessels simultaneously. In addition,he thought protecting stomach Qi should also throughout the whole treatment.