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《金匮要略》虚劳辨治纲要补遗 被引量:1

Supplement to the syndrome differentiation and treatment of the consumptive syndromes in Synopsis of the Golden Chamber
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摘要 《金匮要略》虚劳一证,历来诸多医家对在经旨原意基础之上多有发挥,将虚劳之证归为内伤诸症末节,从气虚、血虚、阴虚、阳虚(或阴阳两虚)分类概括,或与虚、怯、劳、瘵混而谈之,然临床所见诸多虚劳病证,虚实皆现,混而难辨,教材所示五脏气血阴阳各设独立之病证、方药,亦难以随手择取效验于临床。通过对经旨中有关虚劳理论进行梳理与归纳,指出虚劳之治,当以补虚为要,权以调中复衡;气血为辨,施以祛风逐瘀;温养为要,勿忘育阴化气;补虚为基,应遵缓中图治;营卫为法,守机观变达权。并借此管窥仲师血痹虚劳经旨心法所在,以期更好地指导并应验于临床。 A number of doctors of different generations have explored the consumptive syndromes recorded in the Synopsis of the Golden Chamber by Zhang Zhongjing on the basis of its original denotation, categorizing it as the last of internal injuries,generalizing it into the categories of qi deficiency, blood deficiency, yin deficiency, yang deficiency(or deficiency of both yin and yang), or mixing it with deficiency, timidity, fatigue and phthisis. However, in clinical practice, many consumptive syndromes are manifested as a syndrome of intermingled deficiency and excess, which are difficult to distinguish. Textbooks arrange consumptive syndromes by listing them as independent syndromes under the different sub-headings of the five viscera, qi, blood, yin and yang and offering varying prescriptions for them, which is also difficult to be conveniently referred for clinical effective applications.By sorting out and summarizing the relevant theories about the consumptive syndromes in the classical books, it is pointed out in the article that their treatment should prioritize toxifying the deficiency, supplemented by regulating the heart and stomach to resume a balance;their treatment should be based on the syndrome differentiation of qi and blood, dispelling wind and eliminating blood stasis;it is important to warm and nourish the heart and stomach, and to cultivate yin and transform qi as well;their treatment should be based on tonifying deficiency, following the principle of a gradual improvement;they should be treated by dealing with the disharmony between nutrient qi and defensive qi, in line with its pathogenesis to keep an eye on their transitions and to maintain a balance. It is expected that the article can shed a light on Zhang Zhongjing’s purport and treatment methods for bi diseases with the syndrome of blood deficiency and the consumptive syndrome, in order to better guide and apply them to clinical practice.
作者 王桂彬 曹于 庞博 WANG Guibin;CAO Yu;PANG Bo(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing Hospital of Integrated Traditional and Western Medicine,Beijing 100038,China)
出处 《长春中医药大学学报》 2023年第3期252-255,共4页 Journal of Changchun University of Chinese Medicine
基金 北京市自然科学基金面上项目(7222296) 北京市海淀区卫生健康系统高层次人才发展计划项目(2022HDXG003) 第六批北京市中医药专家学术经验继承项目(北京市中医管理局人才项目)。
关键词 虚劳 病机 辨治 思维 consumptive syndrome pathogenesis syndrome differentiation and treatment thinking
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