国医大师路志正应用三仁汤经验举隅

Lu Zhizheng's experiences in the application of sanren decoction

国医大师路志正对治疗湿邪主张用宣、化、渗三法,即开宣上焦,芳化中焦,渗利下焦,尤其强调芳化中焦、健脾祛湿的重要性,常常以调理脾胃作为治疗湿邪的核心。在多年的临床中,路老善用芳香化湿代表方三仁汤加减治疗如胸痹心痛、头痛、眩晕、湿郁发热等各种以湿邪为主要矛盾的疾病。文章以辨病、辨证、随证加减为主,从病因、病机、辨证、方药等角度解析路老在湿浊阻滞之胸痹、湿热眩晕、湿郁发热、气分湿热之湿阻、湿热头痛等病证中应用三仁汤的经验。文章总结了路老对三仁汤功效、方药的理解,并对其加减进行阐释,尽可能地探寻路老应用三仁汤经验的全貌。其用三仁汤以分消湿邪为目标,以调畅气机为原则,以调理脾胃为根本,全方位地对湿邪的来源与去路进行干预,终得到良好的疗效。文章最终的目的在于继承与发扬国医大师的思想,提高中医临床能力。

Lu Zhizheng,the TCM Master proposes the dispersing,resolving and eliminating method in the treatment of pathogenic damp,i. e. dispersing the upper jiao,resolving the middle jiao and draining the lower jiao. In the treatment,strengthening the spleen and removing damp is the core. In the practice,sanren decoction is the representative formula of Master Lu and the modified sanren decoction is applied to various disorders with pathogenic damp predominated,such as chest pain,headache,dizziness and fever due to damp stagnation. In the paper,focusing on the disease differentiation,the syndrome differentiation and the formula modification,in terms of etiology,pathogenesis,differentiation and herbal prescription,the Master Lu’s experiences in the application of sanren decoction were explained in the disorders,i. e. chest pain due to damp blockage,dizziness due to damp heat,fever due to damp stagnation,damp heat stagnation of qi level and headache due to damp heat. The effects of sanren decoction and the understandings in the herbal composition,as well as the modification were elaborated in the paper. It was anticipated to explore the complete experiences of the Master Lu in the application of sanren decoction. The objective of sanrentang application is to resolve pathogenic damp,the principle is to regulate qi activity and the root is to regulate spleen and stomach functions. The satisfactory effects are achieved by the intervention in light of the source of pathogenic damp. The ultimate objective of the paper is to inherit and develop the academic thoughts of TCM master so as to improve the clinical capacity of TCM.