新安医家吴崑《医方考》气血理论思想探析

Analysis of theory of qi and blood in A Textual Research on Medical Prescriptions by Xin’an physician WU Kun

对《医方考》中所体现的吴崑的气血理论思想进行探析。其重视气在人体中的作用,尤其强调元气的重要作用,指出气虚的诊断应当四诊合参,辨证准确后方可补气,临证以顾护元气为首务,喜用独参汤大补元气,并擅以六君子汤培补中气。同时,吴崑认为七情不调可致气病,擅于行无形之气。在营血方面,吴崑受朱丹溪影响,认为阴血易亏而难成。对于血虚之证,其认为应通过药物调和五脏功能以滋补阴血,而非通过药物直接生血。对于出血之证,其指出血热出血当分虚实,实火可攻,虚火可补;下焦出血则以"通""凉"二字立法,引而竭之。在气与血的关系方面,其认为二者互根互用,一损俱损,气血互生,气病可及血,血病可及气,临证治疗应统筹兼顾,气血并调。

This paper analyzes WU Kun’s theory of qi and blood embodied in A Textual Research on Medical Prescriptions.He attaches importance to the function of qi in the human body,particularly stresses on the vital function of primordial qi,and points out that the diagnosis of qi deficiency should comply with synthesis of four diagnostic methods,not until accurate syndrome differentiation does it invigorate qi.In clinic practice,he gives priority to protect primordial qi,prefers to use Dushen Tang(独参汤)to powerfully invigorate primordial qi,in addition,excels at using Liujunzi Tang(六君子汤)to bank up and invigorate gastrosplenic qi.Meanwhile,he holds that disorder of seven emotions can result in qi disease,and excels at regulating intangible qi.In terms of nutrient phase and blood phase,influenced by ZHU Danxi,he holds that it is difficult to produce blood due to its susceptibility to loss.For blood deficiency syndrome,he holds that it should nourish blood by medicinals regulating the function of five zangorgans instead of producing blood by medicinals directly.For bleeding syndrome,he holds that bleeding due to blood-heat should differentiate between deficiency and excess,excess-fire can be purged,while deficiency-fire can be reinforced;bleeding in lower energizer takes the two Chinese characters"dredging"and"cool"as the established method,conducting blood to exhaust.In the aspect of the relationship between qi and blood,he holds that both qi and blood are of mutual root and mutual use,and impairing one causes impairing them both,since qi and blood are of mutual producing,qi disease can affect blood and vice versa.In clinical treatment,it should take both into consideration and simultaneous regulating qi and blood.