基于见病知源观探析张仲景治疗心病的思路

An analysis of ZHANG Zhongjing’s thought on treating heart disease based on the view of seeing disease and knowing its source

医圣张机(字仲景)集众人之所长,编著了经典著作《伤寒杂病论》,创立了六经辨证和脏腑经络辨证体系,书中的一方一药均蕴藏着张机见病知源观的独特诊疗思想。其中,在运用中医临床思维诊疗心血管疾病方面,方药配伍严谨,药少方精,经历代医家验证,临床效果斐然。目前心血管疾病发病率及病死率逐年上升,比如冠状动脉粥样硬化性心脏病(简称冠心病)患病人数高达1100万。部分心系疾病对患者的生活质量、幸福指数有明显的影响,有些甚至对患者的生命健康有极大的威胁。文章对《伤寒杂病论》中涉及心病的主要条文及部分经典方剂进行分析和总结,欲从表证、半表半里证、里证三个方面出发对其条文背后的病机进行深入剖析,其中表证主要从两个角度出发,分别是营卫失和、阳虚邪侵;半表半里证有四个方向,分别是太阳少阳并病、三焦枢机不利、少阳气郁化火和肝郁脾虚;里证主要有三个角度,分别是阴阳两虚、痰气搏结、湿停三焦。从以上角度出发,探索出张机治疗心病的独特诊疗思路和方法,以期为运用中医临床思维诊疗心血管疾病提供一种行之有效的临床思路与方法,使更多的心血管疾病患者能够很好地体会到中医治疗心病的神奇魅力,让患者的生活水平、幸福指数得到一定的提高。

ZHANG Zhongjing,the medical sage,has collected the talents of many people,compiled the classic work Shanghan Zabing Lun(《伤寒杂病论》),and created the system of six meridians syndrome differentiation and the viscera and meridians.Each prescription and medicine in the book contains ZHANG Zhongjing’s unique diagnosis and treatment thought of seeing the disease and knowing the source.Among them,in the application of TCM clinical thinking in the diagnosis and treatment of cardiovascular diseases,the combination of prescriptions and drugs is rigorous,and the drugs are simple and refined,which have been verified by doctors of all dynasties,behalf of others,and the clinical effect is remarkable.At present,the incidence rate and mortality of cardiovascular diseases are increasing year by year,for example,the number of patients with coronary heart disease is as high as 11 million.Some heart diseases have severely influenced the quality of life and happiness index of patients,and some even pose a great threat to the life and health of patients.Through the analysis and summary of the main articles and some classic prescriptions related to heart diseases in Shanghan Zabing Lun,this paper analyzes and summarizes the pathogenesis behind the articles from three aspects:exterior syndrome,half exterior and half interior syndrome,and interior syndrome.There are the disharmony between Yingqi and Weiqi(营卫失和),and the invasion of Yang(阳)deficiency in exterior or syndrome patients.The syndrome of half exterior and half interior has four directions,namely,the combination of Taiyang(太阳)and Shaoyang(少阳)diseases,the disadvantageous pivot of triple energizer,fire due to Qi(气)stagnation of Shaoyang,and liver depression and spleen deficiency.The internal syndrome mainly has three perspectives,namely,Yin and Yang deficiency,phlegm pulsation,and dampness in triple energizer.From the above points,ZHANG Zhongjing’s unique diagnosis and treatment ideas and methods for heart disease is explored,with a view to provide an effective clinical idea and method for the diagnosis and treatment of cardiovascular disease with TCM clinical thinking,so that more patients with cardiovascular disease can well experience the magic charm of TCM treatment of heart disease,so that the living standard and happiness index of patients can be improved to a certain extent.