程文囿从脾辨治疾病经验探析

Cheng Wenyou′s Experience in Differentiating and Treating Diseases Based on Spleen Syndrome

通过对《杏轩医案》中从脾辨治疾病代表医案梳理分析,发现程文囿治疗痰饮水湿之邪相关疾病首辨寒热虚实,恢复脾运使外湿可化,内湿不生,疾病乃愈;气机失调疾病则注重运脾理气,升举脾元,恢复气机升降;血证脾健则统摄有权,化生有源,失血过多急证常益气固脱为先,水火失济治在滋阴敛阳,吐血多以胃药收功意亦在于此。土载四行,五脏中皆有脾气,脾病能够影响五脏,五脏之病亦能通过补益脾土治疗获效,久病正虚,亦多以扶土善后;同时注重体质差异对辨治疾病的影响。本文旨在为临证从脾辨治诸疾提供新思路。

Through combing and analyzing the representative medical records of spleen syndrome differentiation and treatment in Xingxuan Medical Record,it is found that Cheng Wenyou′s treatment of phlegm,drinking,water and dampness-related diseases first distinguishes cold and heat deficiency and excess,restores spleen transport so that external dampness can be converted,and then internal dampness is not produced,diseases are healed.For diseases related to qi dysfunction,he focuses on mobilizing the spleen and regulating qi,raising the spleen element,and restoring qi up and down.For blood syndrome,if the spleen is healthy,it has the power to control,the metaplasia is active,and the acute syndrome of excessive blood loss often replenishes qi and solidifies the body.The treatment of water and fire failure is to nourish the yin and restrain the yang,and this is also the reason of using stomach medicine to treat vomiting blood.The soil carries the four elements,and spleen is in the five internal organs.Spleen disease can affect the five internal organs.The diseases of the five internal organs can also be treated by replenishing the spleen soil.For long-term illnesses and deficiency,doctors often help the soil to treat the aftermath.At the same time,they pay attention to differences in physical fitness to treat diseases.This article hopes to provide new ideas for clinical differentiation and treatment of various diseases based on spleen syndrome.