叶天士《临证指南医案》论治厥证经验

YE Tian-shi’s Discussing Treatment of Jue Syndrome in Guide Cases of Clinical Practice

叶天士以《黄帝内经》理论为指导,师法仲景,在《临证指南医案》中灵活运用脏腑辨证、奇经辨证及卫气营血辨证理论论治厥证。在脏腑辨证中重视厥阴风木,在奇经辨证中重视冲脉之气为病,在卫气营血辨证中重视火热邪气的传变,并提出"肝为刚脏"的理论,根据肝"体阴用阳"的生理特点及脏腑生化关系提出"柔肝通络""缓肝息风""潜阳益乙癸""补胃凝肝""补金柔制""益胃阴伏冲气""通补阳明"等治法,以血肉介类味厚之药填补下焦,通补奇经,选用奇经引经药入冲任脉镇冲逆之气,并重视阴液,拓宽后世论治厥证思路。

Guided by the theory of Huangdi Neijing, YE Tian-shi followed ZHANG Zhong-jing, and flexibly used the visceral syndrome differentiation, Qijing syndrome differentiation, and "Wei Qi Ying Xue" syndrome differentiation theory to treat Jue syndrome in the Guide Cases of Clinical Practice. In the syndrome differentiation of viscera, Jueyin and Fengmu are emphasized;The Qi of Chongmai is regarded as disease in the syndrome differentiation of the Qijing, and the transmission of heat and evil is emphasized in the syndrome differentiation of "Wei Qi Ying Xue". The theory that "the liver is the strong viscera" is put forward, according to the physiological characteristics of the liver, "The body belonging to Yin and its function belonging to Yang", and the biochemical relationship between the viscera. It is proposed to "Rou Gan Tong Luo" "Huangan Xifeng" "Qianyang Yi Yigui" "Buwei Rougan" "Bujin Rouzhi" "Yi Weiyin Fu Chongqi" "Tong Bu Yangming " and other treatment methods, with blood and flesh-based drugs to fill the Xiajiao, tonic the Qijing, use the Qijing to introduce drugs into the Chongmai and Renmai to suppress the Qi, and pay attention to the Yin liquid, which broadens the thinking on the treatment of Jue syndrome for later generations.