吕文良教授辨治黄疸思路探析

Analysis of Professor Lü Wenliang’s thinking of diagnosis and treatment of jaundice

黄疸,是中医肝病临床的常见病,以目黄、身黄、小便黄为典型表现。吕文良教授取仲景“黄家,从湿得之”之说,又结合历代医家之言及临床体会,认为患黄疸者,外感六淫,内伤杂病,皆可为其所因,但以“湿”邪为重,虽有寒化热化之变,然以热化者居多。且湿邪久居,蕴郁肝脾,其肝者调气藏血,脾者行湿统血,若为气郁血伤,热陷血分,则可致瘀热发黄。因此在临证施治时,常以扶正祛邪为纲,以清利湿热、凉血化瘀为主,以养肝健脾、调气和血为辅。并结合患者实情,注意兼证变证,而予以斟酌损益。

Jaundice is a common clinical disease of liver diseases in traditional Chinese medicine,with yellow eyes,yellow body and yellow urine as the typical manifestations.Professor LüWenliang,based on Zhong Jing’s theory that“Huang family,get it from dampness”,combined with the comments of medical experts and clinical experience in the past dynasties,believes that jaundice,exogenous six climatic exopathogens,and internal injuries and miscellaneous diseases can be the cause of jaundice,but the evil of“dampness”is the most important.Although there is a change from cold to heat,most of them are heat.And dampness evil has been living for a long time,accumulating stagnation in the liver and spleen.The liver regulates qi and stores blood,and the spleen regulates dampness and regulates blood.If it is qi stagnation and blood injury and heat trapping blood tier,it can cause blood stasis,heat and yellowing.Therefore,in the treatment of clinical syndromes,it is often to strengthen vital qi to eliminate pathogenic factor as the key link,mainly to clear the dampness-heat,cool the blood and remove blood stasis,supplemented by nourishing the liver and spleen,regulating qi and blood.And combined with the patient’s actual situation,attention and syndrome change,and to consider the profit and loss.