张仲景经方辨治鼻部病证探讨

Discussion on syndrome differentiation and treatment of nasal diseases with ZHANG Zhong-jing’s classical prescriptions

从张仲景著作中涉及到鼻部病证的相关条文入手,探讨鼻部与相关脏器以及经脉存在的络属关系,并将鼻部病证分为鼻中病证、鼻头病证、鼻衄3类;病机归纳为外感风寒湿邪、在内肺气不利;邪热蕴肺、肺气壅塞;阳明邪热内盛、循经上扰,或湿邪内盛、阻滞气机;脾虚肝乘、土败火熄、水邪上泛;少阴邪热循经上扰,或少阴寒水沉于下,虚火上炎5个方面;相应治法总结为宣肺解表通窍,泻肺利水消痈,清解阳明、凉血养阴,温阳散寒、化气祛湿,清降心火、凉血止血等,采用相应经方辨证施治并举例。为临床鼻部疾病的诊治提供参考。

Starting with the relevant articles in ZHANG Zhong-jing’s works concerning nasal diseases and syndromes,this paper discusses the collateral relationship between the nose and related organs and meridians,and divides the nasal diseases and syndromes into three categories:middle nasal diseases,nose head diseases and epistaxis;The pathogenesis can be summarized as exogenous wind cold dampness evil and internal lung qi disadvantageous;Pathogenic heat accumulating in the lung and lung qi obstruction;Yang Ming evil heat is abundant inside and disturbs the meridians,or dampness evil is abundant inside and blocks the qi mechanism;Spleen deficiency and liver hyperactivity,soil and fire extinguishment,and water evil rising;Shaoyin evil heat disturbs the meridians,or Shaoyin cold water sinks at the bottom,and deficiency fire is inflamed at the top;The corresponding treatment methods are summarized as:dispersing the lung,relieving the exterior and opening the orifices,purging the lung,promoting diuresis,eliminating carbuncle,clearing yang,cooling blood and nourishing yin,warming yang and dispersing cold,removing qi and dampness,clearing heart fire,cooling blood and hemostasis,etc.,the corresponding classical prescriptions are used for treatment based on syndrome differentiation and examples.To provide reference for clinical diagnosis and treatment of nasal diseases.