叶天士《临证指南医案》治咳探析  

Exploration of Ye Tianshi’s cough treatment in Case Records as a Guide to Clinical Practice

作　　者：李扭扭[1] 吴晓红[1] 史利卿[1] 董尚娟 马建岭[1] 季坤[1] 白逸晨 李佳珊 宋欢[2] Li Niuniu;Wu Xiaohong;Shi Liqing;Dong Shangjuan;Ma Jianling;Ji Kun;Bai Yichen;Li Jiashan;Song Huan(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078;Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东方医院,北京100078 [2]北京中医药大学

出　　处：《现代中医临床》2020年第4期63-66,共4页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金资助项目(No.81373588);北京市自然科学基金资助项目(No.7192115)。

摘　　要：《临证指南医案》是记录叶天士临床经验的代表著作,其中对咳嗽多有论述,仅咳嗽篇即收载了144则咳嗽医案,较集中地体现了叶天士治疗咳嗽的临床经验及学术思想,通过整理分析该书咳嗽篇所载医案,总结叶天士对于咳嗽的分类、病因病机、证候认识及临证辨治用药特点等。叶天士认为咳嗽分外感、内伤,病位在肺,宜分证辨治。叶天士辨证施治,法古而创新,治疗外感咳嗽总以祛邪为要,注重顾护阴液,治疗内伤咳嗽重脏腑相关,尤其重视肺脾相关、肺肾相关、肺肝相关等病机。叶天士治咳法古而不泥古,善用经方。Case Records as a Guide to Clinical Practice, as the representative work of Ye Tianshi for clinical experience, had lots of discussions on cough with 144 cough cases in it. It particularly reflected his clinical experience and academic ideas of treatment on cough. By classifying and analyzing the cases on cough, we aimed to summarize the classification, etiology and pathogenesis, syndrome differentiation and treatment and characteristics of medication of cough by Ye Tianshi. Our findings showed that Ye Tianshi classified cough into exogenous cough and internal injury cough. In addition, he held that the disease location was in the lung and treatment should be based on pattern identification. For exogenous cough, importance was attached to the removal of pathogens and to care and protection of yin fluids. For internal injury cough, priority was given to zang-fu theory, particularly the relationship between the lung and spleen, the lung and kidney, and the lung and liver, etc. As for cough treatment, Ye Tianshi made the best use of classic prescriptions and he was innovative, not confined by it.

关 键 词：叶天士 临证指南医案 咳嗽 

分 类 号：R256.11[医药卫生—中医内科学]