《临证指南医案》痹症诊疗特色分析

Analysis on the diagnosis and treatment characteristics of arthralgia syndrome in the Lin Zheng Yi An Zhi Nan

从叶天士《临证指南医案》所载痹症医案分析其对痹症的诊治特色,发现叶天士认为痹症的病因病机主要是初病外感风、寒、湿、热或体质阴虚筋脉失养、久病痰瘀混处经络等,治疗上主张从“病之新久、体之虚实、奇经辨证、久病入络、内风致痹、天人相应”6个方面论治,其中的“风气内动致痹论”强调了“体质阴虚,肝木偏亢”在痹症发病中的重要作用,采用“育阴潜阳、息风通络”法而获良效,对后世产生了深远的影响,具体机制值得深入研究。

Analysis of the characteristics of diagnosis and treatment of arthralgia syndrome from the arthralgia syndrome medical case contained in YE Tian-shi's A Guide to clinical practice with medical record.YE Tian-shi's thought,the etiology and pathogenesis of arthralgia syndrome is exogenous rheumatic cold and dampness heat or Body constitution Yin deficiency and vessels lose nourishment,long illness phlegm and blood stasis mixed at meridian and collaterals.In treatment,it is advocated to treat from six aspects:"new affection or Chronic of Diseases,Physical deficiency or reality,syndrome differentiation of eight extra-channel,Chronic Diseases Transforming to Collaterals,arthralgia-syndrome caused by endogenous wind,Correspondence between man and nature.Among those aspect,the theory of arthralgia-syndrome caused by endogenous wind emphasizes the important role of“constitutional yin deficiency,the hyperactivity of liver Yang”in the development of phlegm syndrome,obtaining good effect by using the method of"nourishing yin and burying yang,Calming Wind and unblocking collaterals",has far-reaching influence on later generations and it’s mechanism deserves further study.