基于“心风”理论探讨胃肠神经官能症证治

Study on Treatment of Gastrointestinal Neurosis Based on the Theory of"Heart Wind"

胃肠神经官能症属于《黄帝内经》“心风”范畴,病位在心,兼及脾、胃、肝,基本病机为风邪扰乱心神,病邪为风,兼挟寒、热、痰、滞,治疗以祛风宁心为法。张仲景深化《黄帝内经》“心风”理论,提出11种治疗方法。祛风泻肝法用于肝风逆袭型“心风”,方用奔豚汤;祛风散寒法用于风寒外侵型“心风”,方用桂枝加桂汤;祛风顺气法用于风阻气逆型“心风”,方用桂枝生姜枳实汤;祛风蠲痰法用于风痰痹阻型“心风”,方用枳实薤白桂枝汤;祛风透热法用于风扰热郁型“心风”,方用栀子豉汤;祛风健脾法用于风伤脾胃型“心风”,应心脾同治,方用泻心汤类方;祛风降胃法用于风热伤胃型“心风”,方用黄连汤;祛风豁痰法用于胸膈风痰型“心风”,方用瓜蒂散;祛风温中法用于风寒伤胃型“心风”,方用吴茱萸汤;祛风调肝法用于肝逆犯心型“心风”,方用乌梅丸;祛风行饮法用于风扰饮滞型“心风”,方用桂枝汤去芍药加麻辛附子汤。

Gastrointestinal neurosis falls under the scope of"heart wind"in Huangdi's Internal Classic,with the disease location in the heart and involving the spleen and liver.The basic pathogenesis is wind pathogen disturbing the heart spirit,with the pathogen being wind,accompanied by cold,heat,phlegm,and stasis.The treatment principle is to dispel wind and calm the heart.Zhang Zhongjing deepened the theory of heart wind in Huangdi Internal Classic and proposed 11 treatments.The method of dispelling wind and dispersing the liver is used for the type of heart wind caused by liver wind adverse invasion,so Running Piglet Decoction can be adopted.The method of dispelling wind and cold is used for the type of heart wind caused by wind-cold external invasion,so Cinnamon Twig Decoction with Extra Cinnamon can be adopted.The method of dispelling wind and regulating qi is used for heart wind caused by wind blockage and qi counter-flow,so Cinnamon Twig and Fresh Ginger and Immature Bitter Orange Decoction can be adopted.The method of dispelling wind and purging phlegm is used for heart wind caused by wind and phlegm blockage,so Immature Bitter Orange and Chinese Chive and Cinnamon Twig Decoction can be adopted.The method of dispelling wind and penetrating heat is used for heart wind caused by wind disturbance and heat accumulation,so Gardenia and Prepared Soybean Decoction can be adopted.The method of dispelling wind and invigorating the spleen is used for heart wind caused by wind injuring the spleen and stomach,which should be treated both for the heart and the spleen,so the classified Heart-Draining Decoction can be adopted.The method of dispelling wind and lowering the stomach is used for heart wind caused by wind-heat injuring the stomach,so Coptis Decoction can be adopted.The method of dispelling wind and resolving phlegm is used for heart wind caused by phlegm in the chest and diaphragm,so Melon Stalk Powder can be adopted.The method of dispelling wind and warming the middle energizer is used for heart wind caused by wind and cold damaging the stomach,so Evodia Decoction can be adopted.The method of dispelling wind and regulating the liver is used for heart wind caused by liver invading the heart,so Mume Pill can be adopted.The method of dispelling wind and promoting fluid circulation is used for heart wind caused by wind disturbance and fluid retention,so Cinnamon Twig Decoction removing Shaoyao(Radix Paeoniae Alba seu Rubra)and plus Mahuang(Herba Ephedrae),Xixin(Radix et Rhizoma Asari)and Fuzi(Radix Aconiti Lateralis Preparata)can be adopted.