徐国仟辨治臌胀学术思想探析

XU Guoqian's Academic Thoughts of Differentiating and Treating Tympanites

深入阅读徐国仟先生的学术著作,采用归纳整理、辨证分析的方法,从病因病机、辨证论治、临证典型医案分析3个方面进行总结。徐老提出治疗臌胀重在调理肝脾,认为酒湿虫毒、营养不良、情志六淫等皆可导致肝气郁滞、脾失健运进而发为臌胀,其病位在脾肝,久则及肾。因此,徐老以"去水疏土达木""利水祛邪不伤正"为治法,总的原则是"病初多实宜夺,病久多虚宜补"。"肾主司开阖,肾气从阳则开从阴则关,阳太盛则水道大开,阴太盛则水道常闭",在臌胀后期,徐老认为常规"补肾火壮脾土以制水"收效甚慢,"放水"才能"全土",故择时而用"放水"泻肾之阴水以"全土",以利尿泻肾之阴水。臌胀多属本虚标实,徐老强调治疗时尤应注意攻补兼施、标本兼顾,健脾温肾利水择时而用,"衰其大半而不伤正",中病即止。

In-depth reading of Mr.XU Guoqian's academic works,we summarize his academic thoughts by using the method of induction and sorting,syndrome differentiation analysis,from three aspects of etiology and pathogenesis,syndrome differentiation and treatment,and clinical typical medical case analysis.Mr.XU proposed to treat tympanites by regulating liver and spleen.It is believed that alcohol,dampness,parasites and toxin,malnutrition,emotional changes and six excesses can cause liver qi stagnation,dysfunction of spleen in transportation causing tympanites,which is located in spleen and liver,involving kidney for a long time.On the treatment,he followed the principles of“eliminating water,dredging earth and soothing wood”and“draining water,eliminating pathogen without harming health qi”.The general principle is,“initial diseases being of excess type mostly should be treated with purgation while long-lasting diseases being of deficiency type mostly should be treated with tonification.”“Kidney dominates opening and closing.Kidney opens from yang,closes from yin.Excessive yang causes opening of water passage while excessive yin causes closure of water passage.”Mr.XU believed that the routine“supplement of kidney fire and spleen earth to control water”resulted very slow,so“eliminating water”could“preserve earth”Therefore,it is advisable to use“drainage”in proper time to purge kidney yin water so as to“preserve earth”,purge kidney yin water with diuretic herbs.Tympanites belongs to deficiency in root and excess in branch.Mr.XU emphasized on treatment with both tonification and elimination,combining both root and branch,invigorating spleen,warming kidney and draining water in proper time.“Only half might be weakened.to prevent damaging healthy qi. ”