基于五运六气学说解读陈廷儒丙申年春医案四则  

Interpretation of four medical cases of Chen Tingru in bingshen spring based on the theory of five evolutive phases and six climatic factors

作　　者：周薇[1] 老膺荣[1] 宾炜[2] 吴新明[1] ZHOU Wei;LAO Yingrong;BIN Wei;WU Xinming(Famous Traditional Chinese Medicine Academic Inheritance and Innovation Research Team,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou510120,China;Preventive Treatment Center,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou510120,China)

机构地区：[1]广东省中医院名中医学术传承与创新研究团队,广东广州510120 [2]广东省中医院治未病中心,广东广州510120

出　　处：《中国医药导报》2020年第34期142-145,共4页China Medical Herald

基　　金：广东省中医院顾植山学术经验传承工作室项目(中医二院〔2014〕89号);国家中医药管理局龙砂医学流派传承基地建设项目(国中医药人教函〔2012〕228号)。

摘　　要：因时制宜是中医临床诊疗中应当恪守的重要原则。根据中医五运六气学说,患者起病及就诊时的运气因素对诊治具有重要的意义。本文详细分析了丙申年春季的运气特点,并基于五运六气学说解读清代医家陈廷儒治疗吐血腰痛、经闭寒热、泻吐胸脘痛、丸坠筋痛等四个丙申年春季医案,初步认为丙申年运气因素与疾病的病机及陈廷儒的临床思路之间具有较高的关联性,提示中医临证诊疗过程中,应重视运气理论的应用。时病患者既可伤于运,又可伤于气,甚至俱伤于运气,运气诸要素中,岁运、司天、主运、客运、主气、客气何者为要。当视具体情况,详察病情,细审病机方可得知。另外,解读医案需要考虑运气常位与实情,而运气的致病要素常由患者自气之虚决定。It is an important principle in clinical diagnosis and treatment of traditional Chinese medicine to do the right thing at the right time.According to the theory of five evolutive phases and six climatic factors in traditional Chinese medicine,the factors of yunqi in patients’onset and treatment are of great significance to diagnosis and treatment.Based on the theory of five evolutive phases and six climatic factors,this paper interprets the four spring medical cases of the year of bingshen,which are treated by Chen Tingru,a physician in the Qing Dynasty,for example,hematemesis and lumbago,cold and heat of amenorrhoea,diarrhea and vomiting of chest pain,testical ptosis and tendon pain.It is preliminarily believed that there is a high correlation between the factors of yunqi in the year of bingshen and the pathogenesis of the disease and Chen’s clinical thinking,suggesting that the application of the theory of yunqi should be emphasized in the process of clinical diagnosis and treatment of traditional Chinese medicine.When the disease patients can not only hurt the yun,but also hurt qi,and even hurt yunqi.Among the elements of yunqi,which is the most important one:suiyun,sitian,zhuyun,keyun,zhuqi,keqi.When the specific situation,detailed investigation of the disease,careful examination of the pathogenesis can be known.In addition,to interpret medical cases,we need to consider the status and reality of yunqi,and the pathogenic factors of yunqi are often determined by the deficiency of patients’qi.

关 键 词：五运六气 丙申 春季 陈廷儒 医案 

分 类 号：R2-0[医药卫生—中医学]