叶天士《幼科要略》吐泻证治探析

Analysis of Vomiting and Diarrhea Treatment in YE Tian-shi's You Ke Yao Lue

《临证指南医案·幼科要略》为叶天士幼科证治之概述,其中吐泻篇反映了叶天士治疗幼科吐泻方面的独特经验。叶天士认为感受邪气、伤于饮食、蛔虫动扰、疲药失治等为幼科吐泻的主要致病因素,脾胃所伤是幼科吐泻的核心病机。在临证中注重顾护脾胃,兼顾小儿“年弱质怯”之体,主张用药轻灵精简,究心病情变化注重既病防变思维。旁参张仲景、钱乙、李东垣等名家之论化裁成方古法,对儿科吐泻的学术思想、对于儿科吐泻的辨治体系及临证用药具有重要启发意义,值得进一步挖掘整理。

A Clinical Guide with Case Histories·You Ke Yao Lue is an overview of the syndrome treatment of juvenile department of Ye Tianshi,including vomiting and diarrhea section reflects his unique experience in the treatment of juvenile vomiting and diarrhea.Ye Tianshi believed that the main pathogenic factors of vomiting and diarrhea were the feeling of evil spirit,injury to diet,disturbance of ascaris roundworm and failure of cure of exhausted medicine,and the injury of spleen and stomach was the core pathogenesis of vomiting and diarrhea in children.In the clinical attention to the care of the spleen and stomach,taking into account the children"weak and cowardly"body,advocates the use of light,streamlined,heart disease changes,pay attention to the disease prevention thinking.Beside Zhang Zhongjing,Qian Yi,Li Dongyuan and other famous theory,cut into the ancient method.Ye's academic thoughts on pediatric vomiting and diarrhea have important enlightening significance for the differentiation and treatment system of pediatric vomiting and diarrhea and clinical medicine,which is worth further digging and sorting out.