王维德治疗外科疾病浅探  

An Analysis of Wang Wei-de′s Experience of Treating Surgical Diseases

作　　者：刘镓毓 丛纲[1] LIU Jia-yu;CONG Gang(Nantong Hospital of TCM,Nantong,Jiangsu,China,226000)

机构地区：[1]南通市中医院,江苏南通226000

出　　处：《河南中医》2020年第1期25-28,共4页Henan Traditional Chinese Medicine

基　　金：黑龙江省中医药科研项目(ZHY10-W40)。

摘　　要：王维德确立了外科疾病以阴阳为纲的辨证论治法则。其对痈疽的阴阳辨证,不仅局限于皮肤颜色不同,还从病位深浅、皮肤温度、肿胀形式、肿胀范围、肿块硬度、疼痛感觉、脓液稀稠等方面进行完善。在治疗上,王维德强调:"首贵止痛,痛息则毒散""以消为贵,以托为畏",代表方剂为醒消丸。但不单是以消法贯穿始终,还根据皮损的颜色、肿胀的程度、脓液的稀稠以及病情的演变辨证使用消法和托法。王维德认为,痈与疽的发病机理截然不同,应分而治之。红痈乃阳热实证,白疽乃阴虚寒证,其病机为气血寒而毒凝,应以温补之法治疗,首倡阳和解凝散寒的治疗原则,代表方剂为阳和汤。王维德对于疔毒的治疗,不但主张施以针刺,还选用拔疔散以托毒外出,以免脓毒旁窜深溃。王维德多以清热解毒之法治疗水痘;对天花的治疗则根据病情不同,处以不同方药,病情初期,发热症状明显,可用清热解毒之品,后期热证消散,而出现寒证表现,当停止使用寒凉药物,而改用温补之法。Wang Wei-de has established the principle of syndrome differentiation and treatment of surgical diseases based on yin and yang.In terms of yin-yang syndrome differentiation of carbuncle,not only the different skin color,but also the depth of the disease location,skin temperature,swelling form,swelling range,hardness of the mass,pain feeling,and thickness of pus are considered.In terms of treatment,Wang Wei-de stresses that relieving pain should be put in the first place,because pain stop can lead to dispersing toxin;dispersion method should be adopted while promoting eruption of sore by strengthening vital qi should be avoided.The representative formula is Xingxiao Pill(XXP).He not only uses dispersion method in the whole process of treatment,but uses dispersion method and promoting eruption of sore by strengthening vital qi according to the color of skin lesions,the degree of swelling,the thickness of pus and the evolution of the disease.Wang Wei-de thinks that the pathogenesis of carbuncle and gangrene is quite different,and should be treated separately.Red carbuncle has the syndrome of excessive yang heat,while white gangrene has the syndrome of yin deficiency and cold.Its pathogenesis is cold qi and blood and toxic coagulation.It should be treated with the method of warming and tonifying.It is the first to advocate the treatment principle of harmonizing yang and resolving coagulation and dispersing cold,and the representative prescription is Harmonious Yang Decoction.In terms of furuncle toxin,he not only uses acupuncture,but also Bading Powder(BDP) to eliminate toxin in order to make pus worsening.In terms of chickenpox,Wang Wei-de uses the method of clearing away heat and detoxifying.In terms of smallpox,he uses different formulas and medicines according to the different conditions:At the early stage of the disease,the fever symptoms are obvious,and the products of clearing away heat and detoxifying canbe used.At the later stage,the fever has disappeared,and the cold syndrome begins to appear,so the medicin

关 键 词：《外科证治全生集》 王维德 痈疖 阴疽 疔毒 痘毒 

分 类 号：R26[医药卫生—中医外科学]