张简斋辨治外感咳嗽经验

Zhang Jian-zhai′s Experience of Treating External-Contraction Cough Based on Syndrome Differentiation

《张简斋医案》中的外感咳嗽多为风寒、风热、风燥、风湿、虚人外感咳嗽,其治疗外感咳嗽以辛宣疏化为基本治法,多选轻清、宣散之品,以期轻可去实,根据患者病情,辨证论治,随症加减。张简斋治疗外感咳嗽:①从中医整体观出发,审证求因,治病求本,详辨外感与内伤,谨守病机,根据疾病传变阶段选方用药;②临证用药顾护脾胃,以二陈汤为基本方扶正祛邪、陪土生金;③重视药物性味配伍,多选辛宣理气之药,用药轻灵,契合肺金特性,治疗虚人咳嗽亦有良效;④灵活应用苓桂术甘汤、小青龙汤、沙参麦冬汤、旋覆花汤等古方,师古不泥古;⑤常合用止嗽散,以加强止咳化痰、通利肺气功效。

In Zhang Jian-zhai′s Medical Cases,external-contraction cough includes wind cold cough,wind heat cough,wind dryness cough,wind dampness cough,yin deficiency cough,and yang deficiency cough,dispersing and resolving with pungent medicinals is the basic therapy.The ones which are light and lucid for dispersing can be used to remove excess.They should be modified based on syndrome differentiation.In terms of treating external-contraction cough,Zhang Jian-zhai did so as follows:① Based on the wholism of TCM,he examined the causes,treated the disease and sought the root,distinguished the external and internal pathogens in detail,guarded the pathogenesis,and chose proper prescription according to the stage of disease transmission.② In clinical practice,he paid attention to protecting the spleen and stomach,took Two Matured Substances Decoction as the basic prescription to support the healthy and eliminate pathogenic factors,bank up earth to generate metal.③ He paid attention to the compatibility of nature and taste of medicinals,often chose the pungent ones for dispersing and regulating qi.The light medication fitted the characteristics of the lung,and have good effect on deficient people with cough.④ He could flexibly apply some ancient classical prescriptions such as Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction,Minor Green Dragon Decoction,Radix Adenophorae seu Glehniae and Radix Ophiopogonis Decoction,and Inula Decoction.⑤ He often used Cough-Relieving Powder to strengthen the function of arresting cough and resolving phlegm,dredging lung qi.