陈意教授“调气理论”之临床实践

Clinical Practice of Professor CHEN Yi’s “Qi Regulation Theory”

[目的]总结陈意教授的"调气理论"与遣方用药特色,以期启迪临床。[方法]通过跟师侍诊、揣摩精要,从中医病因病机、汤药方义、随证加减方面分析陈教授临床灵活运用"调气理论"的辨证论治方法,并列举陈教授治疗的疑难杂症医案三则。[结果]陈教授的"调气理论"内涵广泛,重视调畅中焦之气,用药遵循"疏、行、清、灵"四法,辨邪之所在循"散、行、泻、补"四法,处方遵标本缓急,务虚求衡,执中致和。所举验案一为月经淋漓不尽两年余患者,辨为阳气虚、气不摄血,治以益气温阳摄血之法,此乃"虚羸困惫,补即调气"。验案二为经行腹痛患者,辨属寒邪入中,治以活血化瘀、散寒祛风之法,此乃"邪气在表,散即调气"。验案三为黄疸病面色如金患者,治以清热利胆、疏利气机之法,以柴胡疏肝散合五金散加减,用药充分体现"疏、行、清、灵"四法。三则病案虽病情复杂,然收效甚佳。[结论]陈教授以八纲、脏腑辨证为基础,明辨内外表里,重视"调气理论",体现了中医辨证论治疑难病症的优势所在,其经验值得总结与推广。

[Objective] To summarize the characteristics of Professor CHEN Yi’s"Qi regulation theory"and the prescription and medication to enlighten the clinic. [Methods] Through consulting the teacher and figuring out the essentials,this paper analyzed Professor CHEN’s clinical flexible application of the syndrome differentiation and treatment method of "Qi regulation theory"from the aspects of etiology and pathogenesis of traditional Chinese medicine,the meaning and modification of prescriptions,and listed three medical records of Professor CHEN Yi’s treatment of intractable diseases. [Results]Professor CHEN’s "Qi regulation theory"has a wide range of connotations,which attaches great importance to the regulation of Qi in the middle-Jiao,and the principles for prescriptions follows four methods,which are "dispersing,regulating,clearing,lighting". Identify the location of evil and follow the four methods,such as "exhausting Qi,regulating Qi,discharging Qi,tonifying Qi". In the meanwhile,the prescription abides by the rules of identifying the urgency of disease and keeping the inner harmony of Yin and Yang. The patient in the first case was of menstrual bleeding for more than two years,who was identified as deficiency of Yang Qi,and the Qi failed to control the blood. The treatment was tonifying Qi,warming Yang and controlling the blood which reflected the Qi regulation principal of"tonifying Qi". The patient in the second case was of the cold-pathogen attacking and led to the abdominal pain during menstruation,the treatment was to promote blood circulation,dissipate blood stasis,dispel cold and wind,which reflected the Qi regulation principal of "exhausting Qi". The third case was a jaundice patient,the treatment was refrigeration and smoothing the gall by using Chaihu Shugan powder with Wujin powder which reflected the methods of "dispersing,regulating,clearing,lighting". Although the condition of the three medical records was complex,the results were very good. [Conclusion] Professor CHEN’s principles for prescriptions are based on the eightprinciple syndrome differentiation and visceral syndrome differentiation,distinguishing the inside and outside,and attaching importance to the method of"Qi regulation theory",which reflects the advantages of traditional Chinese medicine in treating the intractable diseases and is worth summary and promotion.