王孟英辨治狂证经验撷萃

Wang Mengying's Experience in Syndrome Differentiation and Treatment of Mania

通过研究王孟英著作及医案中的狂证相关内容,结合其疾病诊疗经验,探析王孟英对狂证病因病机的认识和辨治狂证的方法特点。在病因病机方面,王氏认为气机不畅为疾病发生的根本因素,气机不通则生痰、热、瘀。这些病理因素为狂证发生的直接原因,火热扰心、郁痰堵窍、痰火扰神、瘀热互结阻滞正气和阴虚而肝阳盛,煽痰或挟热上扰心神可致发狂;临床治疗方面以调畅气机为首,强调泻热保阴,镇心平肝兼顾脾胃;用药甘凉濡润,汤药共用且善用食疗;同时关注狂证与体质的关系并在狂证治疗中强调辨证,反对一味温补。

Through the study of Wang Mengying's works and medical records related content,combined with his disease diagnosis and treatment experience,this paper analyzes Wang Mengying's understanding of the etiology and pathogenesis of mania syndrome and the characteristics of the method of syndrome differentiation and treatment.In terms of etiology and pathogenesis,Wang thought that qi stagnation was the basic factor of disease occurrence,and the failure of qi mechanism might lead to phlegm,heat and blood stasis.These pathological factors were the direct causes of the occurrence of mania syndrome;besides,fire disturbing the heart,stagnant phlegm blocking the orifices,phlegm fire disturbing the mind,stasis and heat intertwining and blocking qi and yin deficiency,and liver yang excess,phlegm disturbing the mind with heat,would all lead to mania.In terms of clinical treatment,Wang believed that qi movement should be regulated first,which emphasized reducing heat and protecting yin,calming the heart and liver,and taking into account the spleen and stomach;the drugs were sweet,cool and moistening,and drugs should be applied along with decoctions,as well as dietotherapy;at the same time,the relationship between mania syndrome and constitution should also be concerned,and syndrome differentiation was emphasized in the treatment of mania syndrome,and he opposed only paying attention to warming and tonifying.