《张氏医通》辨治咳嗽诊疗特色探析

Analysis application of characteristics of cough diagnosis and treatment in Zhang Shi Yi Tong

张璐为清初医学家,对咳嗽的辨证阐述精辟,治法准确,方药灵活,独具特色。文章通过总结和归纳张璐在《张氏医通》中辨治咳嗽的理法方药,从外邪致咳多兼风、详辨虚实以祛邪,肺胃俱病先安胃、求治中州有法度,心火上炎肺多伤、清心治肺咳乃安,瘀血咳嗽宜细审、攻补兼施以祛瘀,治咳还需法天时、因时治咳以增效5个角度阐释张璐辨治咳嗽的诊疗特色,为后世治疗咳嗽提供临床思路。

ZHANG Lu was a medical scientist in the early Qing dynasty.He explained the syndrome differentiation of cough incisively and accurately,with flexible prescriptions and unique characteristics.The article summarized the principles and methods of treating cough by ZHANG Lu in Zhang Shi Yi Tong.The article explained the characteristics of ZHANG Lu’s diagnosis and treatment of cough from five perspectives.Exogenous pathogens cause more coughs and wind,and detailed identification of deficiency and excess can eliminate pathogens.For both lung and stomach diseases,first relieve the stomach and seek treatment.When both the lung and stomach are sick,the stomach should be relieved first,and there is a law for treating the spleen and stomach.Cough with blood stasis should be carefully reviewed,attacked and supplemented,and applied to remove blood stasis.To treat cough,it is necessary to treat cough according to the time of day and season to increase the effect.It provides clinical thought for treating cough in later generations.