王松龄运用经方吐法治疗精神分裂症经验  

WANG Songling’s Experience in Treating Schizophrenia by Vomiting Method of Classical Prescriptions

作　　者：赵梦雁 骆天炯[2] 王松龄[3] 赵海琪 ZHAO Mengyan;LUO Tianjiong;WANG Songling(Nanjing University of Chinese Medicine,Nanjing(210023),China;Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine;Henan Province Hospital of Traditional Chinese Medicine)

机构地区：[1]南京中医药大学,南京210023 [2]南京中医药大学附属南京市中医院 [3]河南省中医院

出　　处：《浙江中医药大学学报》2020年第4期346-349,共4页Journal of Zhejiang Chinese Medical University

基　　金：南京市名中医骆天烔工作室项目(LTJ-2019-NJ);王松龄全国名老中医传承工作室建设项目(国中医药人教函[2018]134号)。

摘　　要：[目的]总结王松龄教授应用经方吐法治疗精神分裂症的诊疗思路及诊疗经验。[方法]通过临床跟师学习,总结王松龄教授应用中医理论治疗精神分裂症的诊疗思路,详谈精神分裂症病因病机、证型分类及治疗,阐述吐法在临床应用中的依据,并附典型临床案例佐证。[结果]王松龄认为精神分裂症中医属于"癫病""狂病",本病病位在脑,与肝、脾、心、肾相关,多因情志过极,气机紊乱,内邪丛生所致。五情过极,易伤五脏;而五脏亏虚,易受五情所伤。内邪则多为痰、火、气、血、瘀等。临床治疗采用豁痰、降火、理气、化瘀之法。对于痰、火、气、血、瘀等实邪阻滞胸膈、内闭清窍所致的癫狂,使用吐法,使邪有出路,而诸症自平。临床应用时,王教授不拘谨于有无热证,只要病在上者,痰涎阻于胸膈,就可使用加味三物白散涌之,但须注意中病即止。本虚则治以养心健脾补肾、益脑安神。验案中患者诊断为狂证(痰火扰心证),治以清心泻火、涤痰醒神,先以三物白散加减涌吐痰火热邪,而后使用小陷胸汤清除痰热,获得良效。[结论]王松龄治疗精神分裂症详审病机,辨证论治,常应手取效。对于邪居胸膈、内闭清窍所致的癫狂者,应用加味三物白散涌吐效果甚佳,值得临床推广。[Objective]To summarize Professor WANG Songling’s ideas and experience of diagnosis and treatment in treating schizophrenia by vomiting method of classical prescriptions.[Methods]Through clinical learning from teacher,Professor WANG Songling’s ideas and experience of diagnosis and treatment in treating schizophrenia applying the theory of traditional Chinese medicine were analyzed,and the etiology and pathogenesis,classification of syndromes and treatment of schizophrenia were discussed in detail.The basis of vomiting method in clinical application was expounded,and one typical clinical case was presented.[Results]Professor WANG Songling believes that the TCM differentiation of schizophrenia belongs to"depressive psychosis"and"mania".The disease is located in the brain and is related to liver,spleen,heart and kidney.It is mostly caused by emotional overload,Qi disorder and internal evil.If the five emotions are excessive,it is easy to hurt the five viscera;if the five viscera are deficient,it is easy to be hurt by five emotions.Most of the internal pathogens are phlegm,fire,Qi,blood and stasis,etc.The methods of eliminating phlegm,subduing fire,regulating Qi and dispersing stasis are adopted in clinical.For mania caused by phlegm,fire,Qi,blood and stasis and other excess pathogens blocking the thoracic diaphragm and closing the orifices internally,the vomiting method should be used to make excess pathogens way out,and the symptoms are self-healing.In clinical application,Professor WANG is not sticking to heat syndrome or not,as long as the patient suffers from the disease in the upper portion,with phlegm and saliva obstructing the thoracic diaphragm,the modified Sanwubai San can be adopted,and attention should be paid to discontinue medication as soon as get effect.The syndrome of deficiency should be treated with nourishing heart,invigorating spleen and tonifying kidney,benefiting brain and tranquilizing mind.The patient in the case was diagnosed as mania(syndrome of heart disorder due to phlegm and fire),an

关 键 词：精神分裂症 经方 吐法 加味三物白散 中医诊疗经验 癫病 狂病 王松龄 

分 类 号：R228[医药卫生—中医基础理论]