陈士铎论治心悸特色探析

Characteristics of CHEN Shiduo’s Treatment of Palpitation

陈士铎对心悸的辨证论治多从五脏生克关系立足,病因病机方面认为五脏皆可致悸,分别从肝郁化火、肺气不降、心肾不交、脾胃不足等论述病机,针对脏腑的虚实寒热、生克关系以及生理特点创制不同方剂。其治法特点方面首重五行生克制化,兼调气血寒热,强调顾护胃气,扶正为主祛邪为辅。其用药特色方面善用熟地、白芍滋补肝肾、缓急止悸,强调药物性味归经、升降浮沉,同时提出根据疾病深浅、脏腑阴阳属性来决定用法用量、用药时间,对临床脏腑辨证心悸起到一定的指导作用。

CHEN Shiduo often treated palpitation according to syndrome differentiation based on the relationship between the five Zang-organs generation and restriction. In terms of etiology and pathogenesis, CHEN Shiduo thought that any of the five Zang-organs can cause palpitation and discussed palpitation pathogenesis from syndrome of liver depression transforming into fire, dysfunction of lung Qi, heart-kidney non-interaction syndrome, spleen-stomach weakness. He created different formulas according to the deficiency and excess of Zang-fu organs, cold and heat of Zang-fu organs, the generation and restriction of five elements, and the Zang-fu physiological characteristics. In the aspect of the characteristics of the treatment, he focused on the generation and transformation of the five elements, harmonizd the cold and heat of Qi and blood and paid much attention to emphasizing stomach Qi. In addition, his treatment mainly focused on reinforcing healthy Qi, supplemented by eliminating sthenia pathogenic factors. About the medication characteristics, he was good at using Radix Rehmanniae and Radix Paeoniae Alba to nourish the liver and kidney to relieve palpitation, and emphasized the meridian tropism and fluctuation of drug flavor. At the same time, it is proposed that the dosage and medication time should be determined according to the degree of the disease and the Yin and Yang properties of viscera. In the end, his theories played acertain guiding role in clinical viscera syndrome differentiation of palpitation.