《东医宝鉴》中失音的辨治规律浅析

Differentiation and Treatment Rule of Aphasia in Dongui Bogam

《东医宝鉴》是朝鲜太医许浚结合中医学与韩国固有医药学编纂而成的一部医学百科大辞典,于1610年撰成,1613年刊行。《东医宝鉴》以中医诸家理论为基础阐述了人体发声的原理及失音的病因病机和辨治方法,书中所载失音的病因可归为外感、内伤、调摄失宜,其病机可归纳为不通则失音、不荣则失音。《东医宝鉴》中失音分为猝然失音与因杂病失音两类,其辨治以辨证论治为主,参以辨病论治。辨证论治分虚实两端,猝然失音者皆属实证,多为外感风寒之邪所致;因杂病失音者有实证、有虚证,实证多为痰浊、瘀血、热毒阻于喉、舌,虚证多属肺、肾气虚,失音之辨病论治皆可从润燥、清热、宣降肺气而解。失音的针刺取穴尊崇循经而取,多取手少阴、足少阴、足太阴之穴,属舌喑者加廉泉,属喉喑者加天突。

Based on the theories of traditional Chinese medicine,Dongui Bogam explains the mechanism of human voice,and expounds the causes,pathogenesis,syndrome differentiation and treatment of aphasia.According to Dongui Bogam,there are many causes of aphasia,which can be classified into three categories:external infection,internal infection and improper health care.The pathogenesis of aphasia can be summed up as the insufficiency of vital energy and blood in the body and the insufficiency of vital energy and blood in the body.The aphasia can be divided into acute aphasia and chronic aphasia in Dongui Bogam.The discrimination and treatment of aphasia include syndrome differentiation and disease differentiation.The result of syndrome differentiation of aphasia has deficiency and excess.Patients with acute aphasia can be diagnosed as excess syndrome,and most of them are caused by phlegm,blood stasis and heat toxin blocking the throat and tongue.Patients with chronic aphasia can be diagnosed as deficiency syndrome,and majority of them are due to weakness of lung Qi and kidney Qi.The treatment of aphasia can be based on moistening dryness,clearing heat and regulating lung Qi.Acupuncture can also treat aphasia.And acupuncture is used to select acupoints on meridians,and more acupoints on hand Shaoyin,foot Shaoyin,foot Taiyin and Ren Meridian are selected.