范冠杰运用“三仁汤”治疗湿温病的临床辨治思路

Thoughts for the Treatment of Damp-warm Disease with Sanren Decoction by FAN Guan-Jie

总结范冠杰教授运用“三仁汤”治疗湿温病的临床经验。范冠杰教授在运用“三仁汤”辨治湿温病时,提出分析核心病机以确定核心证素,灵活遣方用药、动态因“候”辨治的临床辨治思路。“三仁汤”治疗湿温病的核心病机是“太阴脾虚,湿热蕴结,外感湿热邪气”,其对应的核心证素为“口干不欲多饮,纳食不多,头重如裹,昏蒙眩晕,脘腹胀满,身体困重,大便黏腻不爽,舌苔白腻或黄腻”。临证时若疾病存在湿热邪实内蕴的核心证素,均可灵活使用“三仁汤”,只要动态辨别“湿”与“热”的孰轻孰重,做到因“候”施药,则可提高临床疗效。

The clinical experience of Professor FAN Guan-Jie in treating damp-warm disease with Sanren Decoction(Three-Seed Decoction) was summarized. For the treatment of damp-warm disease with Sanren Decoction,Professor FAN Guan-Jie suggested that the core pathogenesis should be analyzed firstly to define the core syndrome elements,and the flexible medication of the prescription should be based on the differentiation of dynamic syndrome manifestations. The core pathogenesis of Sanren Decoction indicated for damp-warm disease can be summarized as Taiyin spleen deficiency resulting into the accumulation of damp-heat and external attack of damp-heat pathogens. The core syndrome elements of the indications of Sanren Decoction are manifested as dryness sensation in the mouth but unwilling to drink much water,poor appetite,swathing sensation of head,abdominal distention and fullness,heaviness of the body,unsmoothly defecation with loose stool,and whitegreasy tongue fur or yellow-greasy tongue fur. In the clinic,once the patients have the core syndrome elements of internal accumulation of excessive damp-heat, Sanren Decoction can be applied for the treatment flexibly.Satisfactory efficacy will be achieved if the predominance of dampness and heat has been determined and the medication follows the dynamic syndrome manifestations.