吴又可辨治神志异常理论探析及临床启迪

Theoretical Analysis and Clinical Enlightenment of WU Youke's Syndrome Differentiation and Treatment of Mental Disorders

神志异常症状在疫病中非常常见,各个阶段表现不同,极易失治误治。吴又可为明清时期疫病大家,对疫病四个阶段中神志异常症状的病机把握准确,治疗恰当,不同阶段治则方药的侧重点各不相同,逐邪不忘扶正,理气养阴同施,具有重视阳明、顾护正气、保护阴津等特点。他攻不妄攻,补不妄补,以降气升清二法从整体气机进行调治,同时主张护脑先治肠,从通腑与养阴两方面调护胃肠,更紧抓病程,截断扭转先机而治以防脑伤。其诸多治脑神之法方不仅适用于疫病,更可启迪临床,现代诸多脑神病症也可参考施治。

The symptoms of abnormal mind are very common in epidemic diseases.They are different in each stage,and are very easy to be lost and mistreated.WU Youke was a great master of epidemic diseases in the Ming and Qing Dynasties.He accurately grasped the pathogenesis of abnormal mental symptoms in the four stages of epidemic diseases and treated them appropriately.The emphasis of treatment principles and prescriptions in different stages was different.He did not forget to support the vital Qi,regulate Qi and nourish Yin at the same time.He paid attention to Yangming,care for healthy Qi and protect Yin and fluid.He did not attack or supplement rashly.He used the two methods of lowering Qi and ascending Qing to regulate and treat the overall Qi mechanism.At the same time,it is advocated to protect the brain and treat the intestine first,regulating the gastrointestinal tract from the perspectives of clearing the internal organs and nourishing Yin,and more closely grasping the course of the disease,cutting off and reversing the initial opportunity to prevent brain injury.Its many methods for treating brain and mind disorders are not only applicable to epidemics,but also enlighten clinical practice.Many modern brain and mind disorders can also be referred to for treatment.