《时病论》泄泻治法探析

Study on the therapy of diarrhea from Treatise on Seasonal Diseases

清末医家雷丰所著《时病论》具有"法方一体,方随法出"的特点。雷丰秉承经旨,参考诸家之论,将泄泻分为飧泄、洞泄、寒泻、火泻、暑泻、湿泻、痰泻、食泻、饮泻9类,并制定"拟用诸法"用于泄泻的治疗。雷丰某一治法或可用于多类泄泻的治疗,某类泄泻也可包含一种或多种治法。文章对雷丰"拟用诸法"条分缕析并作出归纳统括,分析了各类泄泻的症状、病因病机、治法、方药等内容,探讨了其中蕴含的证治规律,并根据病机概括出健脾燥湿法、温肾补火法、升提固涩法、清凉淡渗法、消导疏利法、药引增效治法,以期深入理解雷丰泄泻治法精髓。雷丰治疗泄泻辨证精严,诸法灵活变通,对泄泻的分类及治法方药均有创见,相关论述对当代中医临床治疗泄泻病具有重要的启迪意义和参考价值。

LEI Feng is a Chinese medicine clinician in the late Qing dynasty.His book Treatise on Seasonal Disease has the characteristics of’therapeutic method and formula is integrated’.Based on the classics and other pubications,LEI Feng divides the diarrhea into sunxie symptoms,dongxie symptoms,hanxie symptoms,huoxie symptoms,shuxie symptoms,shixie symptoms,tanxie symptoms,shixie symptoms and yinxue symptoms.He also presents nine therapy prescriptions for the treatment of diarrhea.In his book,a certain treatment may be used for the treatment of multiple types of diarrhea,and certain types of diarrhea may also include one or more treatments.For the convenience of clinical application,this paper analyzed the symptoms,etiology and pathogenesis,therapeutic methods and prescriptions of various types of diarrhea,and summarized the therapeutic methods of diarrhea based on LEI Feng’s theory.According to the pathogenesis,the treatment methods of diarrhea could be summarized as’invigorating the spleen and drying dampness’,’warming and nourishing kidney yang’,’invigorating qi and inducing astringency’,’eliminating dampness and heat’,’promoting digestion and inducing diuresis’and’increasing the therapeutic effect by guiding drugs’,so as to deeply understand the essence of LEI Feng’s diarrhea treatment thought.LEI Feng’s syndrome differentiation for the treatment of diarrhea is strict,and his various therapy methods are flexible.He also presents original ideas for the classification and treatment of diarrhea.The relevant discussion has important enlightening significance and reference value for the clinical treatment of diarrhea in Chinese medicine.