基于“气分为三”广义脏气分类方法的脾阴虚证探讨

Discussion on spleen-yin deficiency syndrome based on ’qi is divided into three parts’ classification method of visceral-qi

脾阴虚证是客观存在的临床证候,历代医家虽对其有所言及,但缺乏系统全面的论述,亟待研究完善。文章依据“气分为三”广义脏气分类方法,结合文献资料和临床实际,对脾阴虚证的临床表现和遣方用药进行了探讨。认为脾阴虚证以口燥咽干,潮热盗汗,五心烦热,口唇干燥甚或皴裂、起皮、脱屑、渗血、泛红等为临床表现,同时具有舌红少津苔少、脉细数等阴虚证的共有舌脉特点,可以兼见消食善饥、口干、便干等运化太过症状和便血、尿血、肌衄、妇女月经过多等脾不统血症状。临证遣方用药施治,宜遵从《素问·刺法论》“宜甘宜淡”原则,可予芍药甘草汤加黄精、山药、麦冬等化裁。

Spleen-yin deficiency syndrome is an objective clinical syndrome.Although doctors have mentioned it in past dynasties,it lacks systematic and comprehensive discussion,which needs to be studied and perfected urgently.According to the‘qi is divided into three parts’classification method of visceral-qi,combined with literature study and clinical practice,this paper aims to discuss the clinical symptoms,prescriptions and herbs of spleen-yin deficiency syndrome.The clinical symptoms are dry mouth and lips,tidal fever,night sweating,feverish palms and soles,xerocheilia.The tongue is red with less liquid,scanty coating,thready rapid pulse.And the excessive of spleen transportation and transformation symptoms can be seen,as rapid digestion of food and polyorexia,dry mouth and dry stool;or the symptoms of spleen failing to control blood can be seen,as hematochezia,hematuria,sweat pore bleeding,and hypermenorrhea.Clinical treatment of spleen-yin deficiency syndrome should comply with the principle of ‘sweet and mild herbs is priority'in Suwen·Cifa Lun,Shaoyao Gancao Decoction with Huangjing,Shanyao,Maidong can be used as the clinical prescription.