内伤致痹的理法方药研究

Study on the principle-method-recipe-medicines of Bi disease caused by internal injury

在外邪致痹具有较为完善认识的学术背景下,文章据中医经典理论和后世医家认识,阐释饮食失节、情志失常等内伤致痹的理法方药,以丰富痹的理论内涵和临床运用。文章以饮食失节和情志失常为主线,以寒热分类总结叶天士治疗内伤致痹医案,陈皮、半夏和茯苓是治疗饮食失节致痹的基本方,热证时,佐以瓜蒌皮、杏仁、郁金、枇杷叶、淡豆豉等;寒证时,佐以干姜、厚朴、荜茇、枳壳、石斛、紫苏梗等;患者寒热不显或兼具者,采用和法,以基本方为主,灵活佐以上述药物。情志失常致痹,热证者,临床可据患者情况选用瓜蒌皮、杏仁、郁金、枇杷叶、栀子等为主宣展治上或用生地黄、阿胶、玄参、丹参、石斛等滋养治下。寒证者,选用当归、肉桂、小茴香、生香附和南山楂等温通之品;患者寒热不显或兼具者,采用和法,以逍遥散加减治疗。痹的外邪致病因素局限了笔者前期提出的"因痹致痿"病机及通痹治痿法的运用。文章通过丰富痹的致病因素,进一步明晰了该病机的内涵,拓宽了通痹治痿法的运用范围。

Under the academic background of the more perfect understanding of Bi disease caused by external pathogenic factors,according to the classical theory of traditional Chinese medicine and the understanding of later generations of doctors,the article explains the principle-method-recipe-medicines of Bi disease caused by internal injuries such as improper diet and emotional disorder,so as to enrich the theoretical connotation and clinical application of Bi disease.This article takes eating disorder and mood disorder as the main line,and summarizes YE Tian-shi’s treatment of internal injury-causing Bi with cold and heat classification.The exogenous pathogenic factors of Bi disease limit the pathogenesis of’Bi disease resulting in flaccidity symptoms’and the application of Tong bi treatment of flaccidity.By enriching the pathogenic factors of Bi disease,this paper further clarifies the connotation of the pathogenesis and widens the application scope of the method of treating flaccidity through arthralgia.