国医大师葛琳仪论胃心同源同治

Discussion on the Homology and Co-treatbility of Stomach and Heart by TCM Master GE Linyi

[目的]归纳总结国医大师葛琳仪(以下尊称葛老)临床诊治胃心疾病的经验,从而完善葛老的胃心同源同治理论。[方法]通过跟师学习,结合相关古籍和文献资料查阅,从基本结构、生理联系、证候病理等方面总结葛老辨治胃心疾病的学术思想及临床经验。[结果]葛老根据胃心病患者特点及典型症状,结合学术理论,认为胃心解剖部位邻近,形态结构类似,经络联系密切,生理功能协同,证候表现相似,且病理产物相类,以痰饮、瘀血、痰瘀互结为主,而痰瘀互结又会成为新的致病因素影响胃心疾病发展。胃心病临床多见本虚标实或虚实夹杂之证,因而葛老常采用异病同治的思路,治标以清,内寓清补;治本以养,辅以疏利,遵循“正本清源,疏补共用”的原则,以真正实现胃心同治。[结论]葛老在长期临床实践和学术创新过程中认识到了胃与心的相关性,形成了独具特色的胃心同源同治学术理论,为临床诊治胃心疾病提供了宝贵经验与治疗思路。

[Objective] To further summarize the clinical experience of traditional Chinese medicine(TCM) Master GE Linyi in the diagnosis and treatment of stomach and heart diseases,to improve her theory of homology and co-treatability of stomach and heart. [Methods]Through learning from teachers and consulting related ancient books and literature,the academic thoughts and clinical experience of Professor GE in differentiating and treating stomach and heart diseases were summarized from the aspects of basic structure,physiological connection,syndrome,pathology and so on. [Results] According to the characteristics and typical symptoms of patients with stomach and heart diseases,combined with academic theories,Professor GE believes that the anatomical site of the stomach and heart is adjacent,the morphological structure is similar,the meridians and collaterals are closely connected,the physiological function is synergistic,the TCM syndrome is similar,and the pathological products are analogous,mainly phlegm and fluid,blood stasis,phlegm and blood stasis interjunction,which will become a new pathogenic factor affecting the development of stomach and heart diseases. In the clinical practice of stomach and heart diseases,the syndrome of deficiency in origin and excess in superficiality or mixed deficiency and excess are common. Therefore,Professor GE often adopts the idea of homotherapy for heteropathy,cures the superficiality to clear,including supplement;cure the origin by nourishing,supplemented by dispersing. The principle of“reform from the bottom,dispersing and reinforcing together”is followed,so as to truly realize the co-treatability of the stomach and heart. [Conclusion] In the process of longterm clinical practice and academic innovation,TCM Master GE Linyi realizes the correlation between stomach and heart,and gradually forms the unique academic view of the homology and co-treatability of stomach and heart,which provides valuable experience and treatment ideas for the clinical diagnosis and treatment of stomach and heart diseases.