从地黄饮子运用管窥丁甘仁中风治法

Exploration of the treatment of stroke by Ding Ganren from the use of Dihuang Yinzi

通过分析《丁甘仁医案》和《丁甘仁医案续编》中丁甘仁先生治疗中风的23则医案,探索其治疗中风的学术思想,并总结了其对地黄饮子的活用。丁氏认为,虚而生风、痰阻络脉是中风的基本病机,“虚”“痰”是病机的核心要点,而补虚和化痰是地黄饮子的主要功效。丁甘仁先生沿袭孟河医派经验,运用地黄饮子谨守病机,同时,在原方基础上灵活加减祛风、化痰、滋阴药以增效,并与竹沥饮等合方使用。针对类中偏瘫伴呃逆频作等危重情况,丁甘仁先生采取回阳救逆等5大治法进行治疗,其中助阳祛风、化痰通络、益气养血是常见方法,而清泄风阳、和胃化痰则较为少见。

By analyzing the 23 medical records of Ding Ganren′s treatment of stroke in Ding Ganren′s Medical Records and the Continuation of Ding Ganren′s Medical Records,this paper explores his academic thoughts on stroke treatment,and summarizes his flexible use of Dihuang Yinzi.Ding Ganren believes that deficiency causing wind and phlegm blocking the collaterals are the basic pathogenesis of stroke.“Deficiency”and“phlegm”are the core points of pathogenesis,while tonifying deficiency and eliminating phlegm are the main effects of Dihuang Yinzi.Ding Ganren follows the experience of Menghe medical school,and pays attention to the pathogenesis when using Dihuang Yinzi.At the same time,on the basis of the original formula,Ding Ganren flexibly modifies the formula to increase the effect of dispelling wind,eliminating phlegm and nourishing Yin,and uses it with the combination of Zhuli Liquid.In view of the severe condition of hemiplegia with frequent hiccup,Ding Ganren takes five major treatment methods to recuperate depleted Yang.Among them,helping Yang to expel wind,eliminating phlegm and freeing channels,supplementing Qi and nourishing blood are common methods,while cooling fengyang and harmonizing stomach and eliminating phlegm are rare.