汪受传从“四实三虚”辨治小儿鼻衄经验

Professor WANG Shouchuan's Experience in Differentiating and Treating Children's Epistaxis from the Perspective of"Four Excess and Three Deficiency"

总结汪受传教授辨治小儿鼻衄的临证经验。认为小儿鼻衄的病机可概括为“四实三虚”,即肺经热盛、胃火炽盛、心火亢盛、肝火上炎四种实证病机,气虚、阴虚、阳虚三种虚证病机。提出治疗小儿鼻衄七法,即肺经热盛证治宜清肺降气,自拟泻白止衄汤治疗;胃火炽盛证治宜清胃泻火,自拟清胃止衄汤治疗;心火亢盛证治宜清心泻火,自拟导赤止衄汤治疗;肝火上炎证治宜清肝泻火,自拟抑木止衄汤治疗;气虚证治宜补脾益气摄血,自拟扶土止衄汤治疗;阴虚证治宜补肾滋阴清热,自拟滋水止衄汤治疗;阳虚证治宜益气温阳养血,自拟温脾止衄汤治疗。

This paper summarized professor WANG Shouchuan's experience in differentiating and treating children epistaxis from the perspective of"four excess and three deficiency".It is believed that the pathogenesis of children epistaxis is concluded as"four excess and three deficiency",of which the four excess syndromes are exuberant heat in the lung channel,intense stomach fire,heart fire hyperactivity,and liver fire flaming upward,while the three deficiency syndromes include qi,yin and yang deficiency.Seven methods for treating children epistaxis are summarized.For exuberant heat in the lung channel syndrome,it is recommended to clear lung and direct qi downward,using self-made Xiebai Zhiniu Decoction(泻白止衄汤).For intense stomach fire syndrome,the method of clearing stomach and draining fire can be used with self-made Qingwei Zhiniu Decoction(清胃止衄汤).In terms of heart fire hyperactivity syndrome,it is better to clear heart and drain fire,using self-made Daochi Zhiniu Decoction(导赤止衄汤).For liver fire flaming upward syndrome,it is advised to clear liver and drain fire,using self-made Yimu Zhiniu Decoction(抑木止衄汤).In terms of qi deficiency syndrome,the method of fortifying spleen and boosting qi and containing blood should be used with self-made Futu Zhiniu Decoction(扶土止衄汤).If there is yin deficiency syndrome,it is advised to supplement kidney,enrich yin and clear heat,using self-made Zishui Zhiniu Decoction(滋水止衄汤).If there is yang deficiency syndrome,the method of boosting qi,warming yang and nourishing blood can be used,using self-made Wenpi Zhiniu Decoction(温脾止衄汤).