吴鞠通治肝思想指导病毒性肝炎治疗

Wu Jutong′s Thought in Treatment of Liver Diseases for Treating Viral Hepatitis

吴鞠通认为肝主血,亦主络,治疗肝系病症时治络必不可少,应适当予以清胆络法。肝经挟胃两旁,治疗上辅以和胃,且肝经分布于胁肋,肝郁胁痛应从肝络治之。肝开窍于目,肝经上连目系,因此治疗眼部疾病时可从肝络治疗。肝为脏,胃为腑;肝为刚脏,胃为柔腑。俾土衰木乘,调和升降、疏利肝胆是治肝的根本大法。临证治肝不效时,应省查胃之虚实。若兼见胃气不足之证,治疗过程中可兼顾或先处以养胃疏肝之品。病毒性肝炎以正虚为本,湿热为标。治湿热首当疏利气机、调理脾肾、清泻肝胆。病毒性肝炎患者多以脾阳不运、肾阳不温为根本,可从肾治之。温补肾阳方药多温燥,临证在补肾方中加入清泻之品可起到事半功倍的效果,这也是吴鞠通"温肾必助凉肝"思想的具体应用。因此,温肾法也是治疗病毒性肝炎的有效措施之一。

Wu Jutong believes that the Liver governs Blood and the main collaterals.It is necessary to treat the collaterals when treating Liver diseases or syndromes.Therefore,clearing the Heat of gallbladder collaterals should be used.The liver meridian is on both sides of the stomach,and the stomach treatment should be supplemented in the treatment.The liver meridian is distributed in the ribs.The liver is closely related to the eye,and the liver meridian is connected to the eye system,so the liver should also be treated when treating eye diseases.The liver is Zang,and the stomach is Fu;the character Liver is rigid,and that of the stomach is tender.It is the basic law to cure the Liver by reconciling the ascending Qi and the descending Qi as well as reconciling Liver and Gallbladder.When the clinical treatment of liver is ineffective,the deficiency or excessiveness of the Stomach should be checked.If the symptom of insufficient stomach qi is seen,nourishing the stomach and liver can be taken into consideration during treatment.Viral hepatitis is caused by Qi deficiency and Damp-heat.In the treatment of Damp-heat,we should first regulate Qi as well as the function of the Spleen and Kidney,and clear the heat of Liver and Gallbladder.Most patients with viral hepatitis suffer from the Spleen-yang and Kidney-yang deficiency,so it can be treated from the Kidney.The character of prescriptions in tonifying Kidney Yang is always warm and dry,so drugs which can clear Heart should be added into the prescription.This is also the specific application of Wu Jutong′s idea of "Warming Kidney should be helped with cooling Liver".Therefore,warming Kidney method is also one of the effective measures to treat viral hepatitis.