金元四大家狂证诊疗学术思想探析

Academic thought of madness syndrome of Four Eminent Physicians in Jin-Yuan Dynasty

宋金元时期是中医学发展迅猛、民族医学奋起的一个辉煌时期。金元四大家刘完素、李东垣、张子和、朱丹溪作为这一时期著名医家,对狂证的病因到证治皆有各自的发展创新。刘完素主张以火热立论,并善用寒凉之品;李东垣责之为脾虚肝郁,主张火郁发之并同时配合养生以调性情;张子和以阳明胃实立论,并发展以情胜情的心理治疗方法;朱丹溪以痰火立论,主张狂证治疗应"镇心神,开痰结",影响深远。四大医家从病因到证治逐步完善了狂证的诊疗体系,对后世医家的理论研究及临床施治均有重要指导意义。

The Song,Jin and Yuan Dynasties were a glorious period in which Chinese medicine and national medicine developed rapidly.Liu Wansu,Li Dongyuan,Zhang Zihe and Zhu Danxi,the four great doctors of Jin-Yuan Dynasty,were famous physicians in this period.They had their own development and innovation in the cause of madness syndrome and its treatment.Liu Wansu advocated madness syndrome was related to heat,and made good use of cold natured drugs.Li Dongyuan believed that the main reason was spleen deficiency and liver depression,and it had to adjust reconcile mood while dissipate excessive stagnation of fire.Zhang Zihe’s point of view was the excess of stomach and intestine,and he has developed a psychotherapy that uses one mood to correct another mood.Zhu Danxi believed that the cause of the disease was phlegm and fire,and advocated that the treatment principle of madness syndrome should be "calming the mind and expelling phlegm".The four physicians had gradually improved the diagnosis and treatment system of madness syndrome from etiology to syndrome treatment,which has important guiding significance for the theoretical research and clinical treatment of future generations of physicians.