从淋证忌汗看风药在淋证中的应用  

Application of Wind Medicine in Treatment of Stranguria Based on Avoiding Sweating

作　　者：张雪梅 江玉 余海龙 ZHANG Xuemei;JIANG Yu;YU Hailong(Southwest Medical University College of Integrated Traditional Chinese and Western Medicine Affiliated Hospital of Traditional Chinese Medicine,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学中西医结合学院·附属中医医院,四川泸州646000

出　　处：《实用中医内科杂志》2020年第8期16-19,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：黄淑芬全国名老中医药专家传承工作室项目(国中医药人教函〔2018〕134)。

摘　　要：在淋证治疗中有"淋证忌汗"一说,就基本病因病机来看,淋证忌汗无疑有它的合理性,但随着认识的发展,对临床的指导作用和方向也应辨证分析,存在合理性,同时对拟定治疗原则和用药也具有反向启迪意义。首先,要重视"合"病的情况,特别是当淋证合并表证时,仍需要解表,或者表里同治,这就可能用到汗法,甚至得汗而解,此时"淋证可汗"。其次,在没有表证时,"淋证可汗"中其"汗"可以具有更丰富的意思,即取"汗之法"或"汗而开之","汗而散之"而无须见"汗之效"。再者,淋证有膏淋、气淋、劳淋等型,在用药上,不少方药中确实用到具有发汗作用的药或一些祛风解表药,但却并非用其发汗解表的本意,这是基于"风药"理论,取"用风治之"之意。风药味辛、质地轻薄、药性升浮,其具有升浮、发散的特点有"升、散、透、窜、燥、动"等功效。能起到燥湿胜湿、畅气调肝、发散邪热、升阳举陷、活血通络等功效,可用于各型淋证的治疗。列举并分析一些临床上运用风药治疗热淋、气淋、膏淋、劳淋、血淋等淋症的案例,治疗上合理恰当运用风药,是一种具有借鉴意义的思路。About the treatment of stranguria,there was a saying in ancient times that " stranguria treatment should avoid sweating". In terms of the basic etiology and pathogenesis,it undoubtedly has its rationality. However,the author believes that with the development of knowledge,it also has a dialectical analysis of our guiding role and direction,and there is rationality.At the same time,it also has reverse enlightenment significance for us in formulating treatment principles and medication.First of all,we should pay attention to the situation of " combined" disease,especially when stranguria is combined with exteriorsyndrome,we still need to relieve the exterior or treat the exterior and interior simultaneously. Then we may use the method of sweating,or even have to solve it by sweating. Secondly,when there is no external syndrome,the " sweating" in it can have a richer meaning,that is, " sweating method" or " sweating and opening", " sweating and dispersing" without " sweating effect". In the medication,many prescriptions do use the medicine with sweating effect or some drugs for eliminating wind and resolving external symptoms,but they are not the original intention of using it to resolve external symptoms. This is based on the " wind medicine" theory,taking the meaning of " treatingwind". Wind medicine is pungent in taste,light in texture and buoyant in property. It has the characteristics of buoyancy and divergence,such as " rising,dispersing,penetrating,channeling,drying and moving",which can be used to dispel the dampness,regulate the liver,dispense the heat,make spleen-Qi and Yang ascend,activate blood circulationand so on. Therefore,it can be used in the treatment of various types of stranguria.In this paper,some cases of clinical application of wind medicine in the treatment of stranguria such asheat stranguria,Qi stranguria,unctuous stranguria,over-strained stranguria and blood stranguria were cited and analyzed. It is a thought of reference significance to reasonably and properly use wind medicine in the tre

关 键 词：淋证 汗法 风药 玄府 热淋 气淋 劳淋 膏淋 血淋 

分 类 号：R28[医药卫生—中药学]