“水、湿、痰、饮”实质及治疗原则探析

Essence and treatment principle of"water,dampness,phlegm and fluid"

水、湿、痰、饮本属一类,均为脏腑失和、代谢失常、水液运化障碍形成的病理产物,四者之间同源而异流,相互影响,相互转化,兼夹出现,常难以区分界定并影响临床诊疗。本文通过对中医古籍及文献进行归纳分析,从性质、形质、成因、分类、病位、症状诸方面探讨水、湿、痰、饮的特点及性质,揭示水、湿、痰、饮的实质特征。并基于水、湿、痰、饮的实质特征,提出其共性治疗原则,即治病求本、治本用温及助气行水。同时辨析各自特点阐述个性治则,即水病辨阴阳标本论治,湿病辨表里三焦论治,痰病辨寒热部位论治,饮病辨饮停部位论治,以期加深对水、湿、痰、饮内涵的理解,掌握四者之间的界定及相关性,更好地指导中医临床辨证论治。

Water,dampness,phlegm and fluid belong to the same category,they are all pathological products of abnormal metabolism of viscera and disorder of water transport.The four are of the same origin and different flow,influence each other,transform each other and appear at the same time,which is often difficult to distinguish and define and affect clinical diagnosis and treatment.Based on the analysis of ancient books and literatures of traditional Chinese medicine,this paper discusses the characteristics and properties of Water,Dampness,Phlegm and Fluid from the aspects of nature,shape and quality,causes of formation,classification,disease location and symptoms,and reveals the essential characteristics of water,dampness,phlegm and fluid.Based on the essential characteristics of water,dampness,phlegm and fluid,the common treatment principles of water,dampness,phlegm and fluid are put forward:looking for the basic causes in treating diseases,using mild medicine to cure diseases,and running Qi and fluid.At the same time,analyze their own characteristics and expound the individual principles,differentiate Yin and Yang in water diseases,differentiate triple energizer and exterior interior in dampness diseases,differentiate cold heat and location in phlegm diseases,differentiate location in fluid.In order to deepen the understanding of the connotation of"water,dampness,phlegm and fluid",master the definition and correlation of the four,and better guide the clinical differentiation and treatment of traditional Chinese medicine.