《辨证录》辨治不寐探析

Analysis on diagnosis and Treatment Characteristics of Consumptive diseases in “Bianzheng Lu”

陈士铎在《辨证录》中全面阐释了不寐的基本病机“心肾不交”,以其为病机中心,采用五行生克理论进行脏腑辨证,重视肝胆和心肾的相互关系,论治上取古人意而不泥古人法,多有见解独到之处。摒弃历来以大剂量黄连直折心火,小量肉桂为臣以交通心肾的思想,摒弃大寒大热的治疗方式,主张等量小量一温一凉纠其偏性,强调心肾同病、心肾同治,其对心肾不交的理解和治疗理念,充实和拓展了心肾不交的理论范畴。该文探析《辨证录》“不寐门五则”证治特色,以期有益于临证。

CHEN Shiduo comprehensively explained the basic pathogenesis of insomnia, “heart-kidney imbalance”, in Bianzheng Lu, taking it as the center of pathogenesis, adopting the theory of generation-inhibition in five elements for viscera syndrome differentiation, attaching importance to the relationship between liver and gallbladder and heart and kidney. There are many unique opinions on treatment variation, which are taken from the ancients but not limited to them. Abandon the idea that a large dose of Huanglian removes heart fire and coordinates the heart and kidney with a small amount of cinnamon. Abandon the treatment mode of major cold and heat. A small amount of Huanglian and cinnamon is advocated to correct its bias by one temperature and one cool, emphasizing the heart and kidney dual disease and heart and kidney harmonic treatment. His understanding and treatment of heart-kidney imbalance enriched and expanded the theoretical category of heart-kidney imbalance. This paper analyzes the characteristics of syndrome treatment of “Five principles of insomnia” in Bianzheng Lu, in order to benefit clinical treatment.