新安医家王仲奇辨治中风医案特色探析

Analysis of Therapeutic Characteristics of Xin’An Famous Clinician WANG Zhong-qi in Treating Stroke

新安医家王仲奇在《王仲奇医案·中风》中详述中风诸案,其辨治特色对于中风的临床诊治大有裨益。本文运用古今医案云平台分析医案中临床症状、脉象、治法、中药和药物属性并加医案典例阐释。王仲奇认为中风虽病位于脑,实与心、肝、脾、肾关系密切,肝肾阴虚是病机关键,其次是痰瘀阻络。其中风临床医案篇相对于中风常用的镇肝息风、豁痰开窍、活血通络等治法,更侧重于安神养脑、补肝肾及息风豁痰。常用甘枸杞、女贞子补益肝肾,牡蛎、龙骨、茯神等补虚安神,半夏、天麻息风豁痰,豨莶草、鹿衔草、威灵仙等补肾强筋骨,因脑为髓海,肾主骨生髓,肾精足则髓足,髓足则脑充,治疗上体现了肝肾并补、安脑生髓及息风豁痰的特色。

WANG Zhong-qi,a Clinician of Xin’an,elaborated on various cases of stroke in his book'WANG Zhongqi’s Medical Records-Stroke'.Its differentiation and treatment features are of great benefit to the clinical diagnosis and treatment of stroke.In this paper,the clinical symptoms,pulse condition,treatment,traditional Chinese medicine and drug properties in medical cases are analyzed by using the ancient and modern medical case cloud platform and to explain them with medical cases.WANG Zhong-qi believes that although stroke is located in the brain,it is closely related to heart,liver,spleen and kidney.Insufficiency of Qi and blood or deficiency of liver and kidney Yin are the key factors of pathogenesis.Among them,the wind clinical cases,compared with the commonly used treatment methods for stroke,such as reducing liver wind,removing blood stasis,clearing away phlegm,activating blood circulation,etc.Focus more on calming the mind and nourishing the imagination of liver and kidney.Oyster,keel,Fushen and other tonifying and tranquilizing herbs are commonly used,and Siegesia sieboldii,Lu Xian Cao,Weilingxian and other kidney-strengthening and bone-strengthening herbs are used too.It is believed that the brain is the sea of marrow,the kidney is the main bone to produce marrow,the kidney is full of essence,and the marrow is full of brain.The treatment embodies the characteristics of both liver and kidney supplementation,wind extinguishing and phlegm eliminating.