许家栋对张仲景“四饮”病机与治法的思路探讨

Xu Jiadong’s discussion on Zhang Zhongjing’s pathogenesis and treatment of Siyin(retention of body fluid in four forms)

许家栋教授通过“痰饮”即为“淡饮”入手,结合《金匮要略》条文辨出痰饮病机特点为胃虚津液不化、下焦饮逆。当痰饮以水饮为主时,治疗方法以温化为主温补为辅;当痰饮以虚寒为主时,治疗以温补为主温化为辅;当痰饮病传中焦胁下变为悬饮,病机特点为中焦水饮阻滞,水结化热,治法可攻之;当痰饮病传上焦表位成为溢饮,病机特点为表位水饮凝滞有余,治疗为汗法。支饮的病机最复杂,同时具有痰饮、悬饮、溢饮的病机特点,需以法治之。本文通过对四饮病机、理法方药的探讨,为临床辨治水饮病提供诊疗思路。

Professor Xu Jiadong began with“phlegm drinking”as“light drinking”,combined with the provisions of“Synopsis of the Golden chamber”,identified the pathogenesis of phlegm drinking as stomach deficiency,body fluid retention,lower energizer drinking reverse.When phlegm drinking was mainly water drinking,the treatment was mainly warming and supplementing.When the phlegm drink is mainly deficient and cold,the treatment is mainly warming and tonifying,supplemented by warming and warming.When the disease of phlegm drinking becomes suspended drinking under the central coke side,its pathogenesis is characterized by the block of the central coke water drinking and the heat of water condensation,and the treatment can attack it.When the disease of phlegm drinking is transmitted to the focal surface and becomes excessive drinking,the pathogenesis of the disease is characterized by excess stagnant water drinking at the focal surface,and the treatment is perspiration.The most complicated pathogenesis of Zhiyin is phlegm drinking,suspended drinking and overflowing drinking,so it needs to be ruled.This paper discusses the pathogenesis of the four drinking diseases and the rational and legal prescriptions,and provides the diagnosis and treatment ideas for the clinical differentiation and treatment of water drinking diseases.