王键治疗痞满经验  

WANG Jian’s experience in treatment of distention and fullness

作　　者：胡建鹏 丁玲 王丽娜 李佩佩 王键 HU Jian-peng;DING Ling;WANG Li-na;LI Pei-pei;WANG Jian(Guoyitang Outpatient Department of Anhui University of Chinese Medicine,Hefei 230038,China)

机构地区：[1]安徽中医药大学国医堂门诊部,合肥230038

出　　处：《中华中医药杂志》2020年第8期4000-4003,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家科技支撑计划项目(No.2012BAI26B01);第四批全国中医优秀人才项目(No.国中医药办人教发[2017]24号)。

摘　　要：中焦气机不利,脾胃升降失司,是痞满发病的基本病机特点,可由感受外来之邪、内伤饮食、痰湿阻滞、情志失调、脾胃虚弱等所致。痞满病位在胃,与肝、脾等脏腑关系密切,病理性质包括虚、实两端,且可互相转化。临证辨治痞满,以辨别虚实为要,实即实邪内阻,虚者如脾胃虚弱(多为气虚或阴虚)。初病多实,久病多虚,患者多表现为虚实相兼,故辨痞满须辨清虚实。王键教授继承新安王氏内科经验,临床辨治痞满综合应用健脾和胃、疏肝理气,养阴益胃、健脾理气,温中化湿,理气和中等法。尤其善用经方、名方与对药、角药,注重肝脾胃同治与辛开苦降之法,使脾复升运、胃复和降、升降相济,力求病方、证法、药证相应,故而疗效显著,对中医的临床辨治痞满有着较好指导意义。The disorder of qi activity of middle jiao and dereliction of duty of the spleen and stomach are the characteristics of the basic pathogenesis of the distention and fullness.It can be caused by feeling foreign exopathogen,internal injury diet,phlegm-dampness block,emotional disorder,spleen and stomach weakness.The disease is in the stomach and involves the liver,spleen and other viscera close relationship.The pathological properties are nothing but asthenia and stheia,and can be transformed into each other.It is the most critical point for diagnosing and treating the distention and fullness to distinguish the asthenia and stheia.The asthenia means asthenia pathogenic factors are internal resistance.The stheia includes the spleen and stomach are weak(mostly qi deficiency or yin deficiency).The initial illness is more likely to be an asthenia,and the chronic illness is more likely to be a stheia.The patients’performance includes both asthenia and stheia.Therefore,it is necessary to distinguish the asthenia and stheia.Professor WANG Jian inherits the experience of Xin’an WANGs’medicine and uses the comprehensive methods of Jianpi Hewei,Shugan Liqi,Yangyin Yiwei,Jianpi Liqi,Wenzhong Huashi and Liqi Hezhong to treat the distention and fullness.On the one hand,professor WANG makes good use of the application of classics prescription,famous prescription and to medicine,horn medicine.On the other hand,he pays attention to the synergistic treatment of liver,spleen and stomach and acrid opening and bitter down bearing.The result is the spleen recuperate and transport,stomach recuperate and fall,rise and fall together.It strives to‘all diseases correspond to prescriptions’and‘all syndromes correspond to the treatment’,so the effect is significant,and has a good guiding significance for the clinical application of Chinese medicine.

关 键 词：痞满 病机 治法 经验 

分 类 号：R249[医药卫生—中医临床基础] R256.32[医药卫生—中医学]