吴门医家叶天士胃脘痛辨治特色探析

Brief Study on the Experience of Wumen Doctor YE Tianshi in Diagnosing and Treating Epiagstric Pain

通过分析叶天士《临证指南医案》、《叶氏医案存真》等著作中关于治疗胃脘痛的病案,总结叶天士治疗胃脘痛的特色。发现叶氏辨治胃脘痛时,着眼于全身气机升降平衡在胃脘痛发病中的作用,重视肝与胃、肺与胃之间的关系,多用疏肝和胃、降肺理气法;胃脘痛久病、重病从络病理论辨治,实证祛邪通络,虚证则补虚通络,常用辛香药和虫类药。此外,叶氏将胃阴学说运用在胃脘痛治疗中,常用滋补胃阴法。

To summarize YE Tianshi’s features of treating epiagstric pain,by analyzing his case records in medical books such as A Guide to Clinical Practice with Medical Record and YE’s Authentic Medical Records.We have find that YE Tianshi has focused on the role of ascending and descending balance of Qi activity of the whole body in the pathogenesis of epiagstric pain and emphasizes the relation between liver and stomache,lung and stomache.He has often used the therapy of soothing liver and harmonizing stomach,depressing and regulating Qi activity of the lung.Chronic and serious epigastric pain has been treated by collateral theory:sthenia syndrome has been treated by eliminating pathogens and dredging collaterals,while deficiency syndrome has been treated by tonifying deficiency and dredging the collaterals.Spicy medicine and worm medicine have been often used.Besides,he has applied the stomach-Yin theory in the treatment of epiagstric pain,and the thrapy of nourishing the stomach-Yin has beenb often used.