浅析叶天士《临证指南医案·癥瘕篇》用药特点及学术思想

A brief analysis of medicine characteristics and academic thoughts in Ye Tianshi's Medical Case in Clinical Guide·Mass Syndrome

目的:通过统计叶天士《临证指南医案•癥瘕篇》用药情况,分析其用药特点及学术思想,为临床治疗符合癥瘕病表现的相关疾病提供新思想、新方法。方法:选择癥瘕篇中的用方及用药,并进行筛选、记录选用的用药,按照用药频次、四气五味、归经及功效分类,将出现的频次排列成表格。结果:统计分析可知叶氏在癥瘕篇中使用频次最多的药物是当归、茯苓。“五味”使用频次最多的是辛味,“四气”使用频次最多的是温性,“归经”使用频次最多的是肝经。功效分类使用频次最多的是补虚药。结论:叶天士在癥瘕病的用药特点及学术思想为:药味精简,巧用血肉有情之品。以温补为主,不妄攻伐。从气血论治,理气活血并用。

Objective:To provide new ideas and methods for the clinical treatment of related diseases conforming to the manifestations of symptomatic disease through the statistics of medicine use in Ye Tianshi's Medical Case in Clinical Guide·Mass Syndrome.Methods:The prescription and medicine used for Mass Syndrome were selected,screened and recorded,and classified according to the frequency of medication,four properties and five tastes,meridian tropism and effect,the frequency of occurrence was arranged in tables.Results:Statistical analysis shows that Angelica sinensis and poria cocos are the most frequently used drugs in Ye's treatment of Mass Syndrome.The most frequently used“five tastes”is pungent,and the most frequently used"four property”is warm.The most frequently used"meridian tropism"is liver meridian.The most frequently used drugs are tonic drugs.Conclusion:Ye Tianshi's medication characteristics and academic thought in the treatment of symptomatic diseases are as follows:the taste of medicine is simple,and the flesh and blood products are skillfully used.We should give priority to warming and tonifying,and do not attack rashly.Treatment starts from Qi and blood,regulating qi and activating blood.