龚廷贤《寿世保元》论治痛风思想  

Gong Yan-xian’s Idea of Treating Gout in Prolonging Life and Preserving the Origin

作　　者：王陈妮[1] 刘燕[1] WANG Chen-ni;LIU Yan(Anqing Medical College,Anqing,Anhui,China,246052)

机构地区：[1]安庆医药高等专科学校,安徽安庆246052

出　　处：《河南中医》2020年第2期199-202,共4页Henan Traditional Chinese Medicine

基　　金：安徽省高等学校自然科学重点研究项目(KJ2018A0937)。

摘　　要：明代医家龚廷贤在《寿世保元》中指出,痛风的发生为内外因共同作用所致,肝肾不足,脾失健运,气血虚弱为本,痰湿瘀血内结,外感风寒暑湿之邪为标,属本虚标实证。其治疗痛风以虚实为纲,气血为本,如辨为气血不足者,用参五秦艽汤加减补益气血,祛风散寒除湿;如辨为营卫失调者,用续断丸以益气养荣,补益肝肾;如辨为风湿痹阻者,采用消风饮祛风除湿,通络止痛;如辨为湿热内蕴者,采用二妙散清利湿热,通络止痛;如辨为瘀血痹阻者,采用舒筋散温通经脉,活血散瘀;如辨为痰瘀互结者,采用赶痛汤活血祛痰通络;如辨为劳倦过度者,采用十全大补汤益气补血等。治则明确,或攻、或补、或攻补兼施,以固护脾胃,调理气血为特点;治法灵活,补虚以健脾补肾,补益气血为主,配以祛风、散寒、除湿、清热、化痰、行瘀等攻邪治法;提倡内外兼治,善用中药内服及熨法、雷火针法外治;组方严谨,药物配伍以寒热并用、固护脾胃、重调气血为特点。Gong Yan-xian,a famous doctor in the Ming Dynasty,pointed out in Prolonging Life and Preserving the Origin that gout is caused by internal and external factors,liver and kidney deficiency,spleen dysfunction,qi and blood weakness,intermingled phlegm dampness and blood stasis,external wind,cold and heat dampness,which belongs to the syndrome of root deficiency and branch excess. The treatment of gout is based on deficiency and excess,qi and blood. For deficient qi and blood,Modified Shen Wu Qin Jiu Decoction can be used to nourish qi and blood,remove wind,cold and dampness. For ying-wei disorder,Teasel Root Pill can be used to nourish qi and liver and kidney. For wind-damp syndrome,Wind-Dispersing Decoction can be used to remove wind and dampness,dredge collaterals and relieve pain. For damp heat accumulated in the body,Two Mysterious Powder can be used to remove heat and dampness,dredge collaterals and relieve pain. For blood stasis blocking channels,Powder for Relaxing Muscles and Tendons can be used to warm and dredge channels,activate blood circulation to dissipate blood stasis. For intermingled phlegm and blood stasis,Pain-removing Decoction can be used to activate blood circulation,remove phlegm and dredge channels. For excessive fatigue,Perfect Major Supplementation Decoction can be used to nourish qi and blood. The treatment principle is clear,which is characterized by strengthening the spleen and stomach and regulating qi and blood by attacking,nourishing,or attacking and nourishing together. The method of treatment is flexible. The main method of tonifying deficiency is invigorating the spleen and kidney,tonifying qi and blood,combined with eliminating wind,dispersing cold,removing dampness,clearing heat,resolving phlegm and removing blood stasis. He advocates internal and external treatment,making good use of TCM for internal administration,ironing and external treatment with thunder-like miraculous needling. His prescriptions are rigorous,and the compatibility of drugs is characterized by the combinatio

关 键 词：《寿世保元》 龚廷贤 痛风 

分 类 号：R249.1[医药卫生—中医临床基础]