邱根祥教授诊治小儿脾胃病学术特色探析

Academic characteristics of professor QIU Genxiang in diagnosis and treatment of children with gastrosplenic disease

从以下5个方面总结探析了邱根祥教授诊治小儿脾胃病的学术特色。1)首重望诊,通过观神色定病势,审苗窍定病位,察指纹定病性,灵活地将望诊、问诊、闻诊及脉诊四诊有机结合起来,全面掌握病情。2)脾常不足是小儿的生理特点,也是小儿脾胃内伤发生的主要病理基础,故健运脾胃是小儿脾胃病的治疗关键,应"补""运"结合,且贯穿于防治小儿脾胃病的始终。用药主张采用补气健脾药、化湿健脾药、理气健脾药,同时加柔润和胃及开胃助纳之品,尽量选择甘味药,少用过于苦涩浓烈的药物。另外,邱教授注重脏腑之间的联系,强调调和他脏以补脾胃,常加疏肝、宁心、补肾、调肺之品。3)临证立法处方颇具雷氏医学特色,强调以法代方,不仅要抓住疾病的一般规律,还要根据患儿体质、病邪性质、病情程度、时令气候等不同而选择相应的治法。遴选成方、善化古方,治疗时灵活变通,知常达变,抓住主要病机关键,随证立法。4)用药审慎,以平为期,以和为贵,多选用轻灵平和药物,同时争取做到一药多用、药尽其用。治疗时通过平衡之法,达到中焦平和,脾胃功能恢复如初的目的。5)平时注意内外合治,并运用一系列外治方法(小儿推拿、熏洗、贴脐法、敷贴法、足浴法、涂擦法、耳穴压豆法等),同时注重小儿调护,强调防治并重。

This paper summarizes and analyses professor Qiu Genxiang’s academic characteristics in diagnosis and treatment of children with gastrosplenic disease from the following 5 aspects:1)Giving priority to inspection,through inspection of spirit and complexion to determine the state of the disease,through inspection of orifices to determine the location of disease,observation of finger venule to determine the nature of disease.Flexibly combine inspection,inquiry,listening and smelling,and pulse diagnosis to master the condition comprehensively.2)Frequent insufficiency of spleen is the physiological characteristics of children,it is also the main pathological basis of spleen and stomach injury in children,thus invigorating and activating spleen and stomach is the key to treat children with gastrosplenic disease.It should span the whole course of preventive treatment of children with gastrosplenic disease to combine invigorating with activating.The medication advocates using invigorating qi to strengthen spleen medicinal,resolving dampness to strengthen spleen medicinal and regulating qi to strengthen spleen medicinal.Meanwhile,adding medicinals of soothing,moistening and harmonizing stomach as well as promoting appetite and strengthening intake of food.Selecting sweet medicinal as far as possible and less using too bitter,astringent and drastic medicinal.In addition,professor QIU focuses on the correlation between zang and fu organs,emphasizing harmonizing other viscera to invigorate spleen and stomach,often adds the medicinals of soothing liver,tranquilizing mind,tonifying kidney and regulating lung.3)In clinical practice,he makes prescription based on therapeutic principles,which possesses LEI’s medical characteristics,and emphasizes taking therapeutic principles to replace the prescription.Not only does he grasp the general rules of the disease,but also selects different therapeutic methods according to different constitutions of the children patients,the nature of the pathogenic factors,the degree of pathogenic conditions,seasonal changes and climate etc.Selecting set prescription and excelling at ancient prescription,he treats flexibly by knowing the commonly encountered disease to acquire the deteriorated syndrome,grasps the main key to the pathogenesis,and works out a therapy according to syndromes.4)Prudent in medication,taking balance as the expectation and harmony as the priority,mostly selecting light and mild medicinal,meanwhile,striving to achieve a multi-purpose medicinal,and making the best use of every medicinal.The method of balance is used during the treatment,whereby it achieves the purpose of harmonizing middle energizer and recovering the functions of the spleen and stomach as before.5)Paying attention to internal and external treatment in normal treatment,and applying a series of external treatment methods(pediatric tuina,fumigation,application on navel method,application method,foot bath method,smearing and rubbing manipulation,auricular-plaster therapy),meanwhile,focusing on child nursing and care,and emphasizing prevention and treatment.