从“阳和化疽”到“温通治痈”——论浙江楼氏乳科对《外科证治全生集》的继承和发展  

From“Yang-harmony Remedy for Carbuncle”to“Warming and Dredging Treatment of Carbuncle”——the Inheritance and Development Made by Zhejiang LOU’s Breast Surgical School on the Basis of the Theories of“Waike Zhengzhi Quansheng Ji”

作　　者：吕政仪 楼丽华[2] 聂云梦 沃立科[2] 赵虹[2] LYU Zhengyi;LOU Lihua;NIE Yunmeng(Zhejiang Chinese Medical University,Hangzhou(310053),China;The First Affiliated Hospital of Zhejiang Chinese Medical University)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江中医药大学附属第一医院

出　　处：《浙江中医药大学学报》2021年第6期565-570,共6页Journal of Zhejiang Chinese Medical University

基　　金：国家自然科学基金项目(81703368);全国名老中医药专家传承工作室建设项目(国中医药人教发[2014]20号)。

摘　　要：[目的]介绍全生外科"阳和化疽"学说和楼氏乳科"温通治痈"理论,论述楼氏乳科在乳房阴证性疾病的诊治方面作出的理论继承和创新发展。[方法]通过归纳《外科证治全生集》具体条文,总结浙江楼氏乳科临床实践经验和学术思想,从理辨、治法、方药方面,分别阐述"阳和化疽"学说和"温通治痈"理论并指出楼氏乳科对全生派学说的完善之处和创新点。[结果]在理辨方面,《外科证治全生集》"阳和化疽"学说首次分辨痈疽的阴阳属性,独重望诊,认为疽属于阴虚证,指出内吹乳痈为阴证;楼氏乳科在全生派学说的基础上提出"温通治痈"理论,提倡四辨识病,主张包括非哺乳期乳腺炎、哺乳期乳腺炎在内的乳痈均属于标阳本阴证。在治法方面,全生派重视阳和化疽,温开慎补,以消为贵,以托为畏,忌惮刀针;楼氏乳科在其基础上注重温通治痈,主张消托并举并结合穿刺抽脓等现代外治法,内外兼治。方药方面,楼氏乳科在全生派阳和汤基础上创楼氏融冰汤。[吉论]浙江楼氏乳科"温通治痈"学术思想是"阳和化疽"学说在乳腺专科的重要发挥发展和完善了乳房阴证性疾病的中医诊治,为哺乳期乳腺炎、非哺乳期乳腺炎的诊断和治疗开拓了思路。[Objective]To introduce the theories of"Yang-harmony remedy for carbuncle"and"warming and dredging treatment of carbuncle"in Zhejiang LOU’s breast surgical school,so as to discuss the theoretical inheritance and innovation of Zhejiang LOU’s breast surgical school in the diagnosis and treatment of Yin syndrome breast diseases.[Methods]Through summarizing the specific articles of"Waike Zhengzhi Quansheng Ji"and the academic thoughts of Zhejiang LOU’s breast surgical school,the theories of"Yang-harmony remedy for carbuncle"and"warming and dredging treatment of carbuncle"were expounded respectively from the aspects of syndrome differentiations,treatments and prescriptions,and the improvement and innovation of LOU’s breast surgical school on the theory of Quansheng school were pointed out.[Results]In terms of syndrome differentiation,the theory of"Yangharmony remedy for carbuncle"in"Waike Zhengzhi Quansheng Ji"firstly distinguished the Yin and Yang attributes of carbuncle and gangrene depending on inspection,and thought that gangrene belonged to Yin and deficiency syndrome,then pointed out that lactation mastitis belonged to Yin syndrome;LOU’s breast surgical school puts forward the theory of"warming and dredging treatment of carbuncle"on the basis of"Yang-harmony remedy for carbuncle",advocates for following four patterns in identifying diseases,and puts forward that all kinds of mastitis,including non-lactation mastitis and lactation mastitis,belongs to"the Yin disease with Yang symptoms".In terms of treatment methods,Quansheng school applied the means of warming,opening and nourishing in order to dissolve lumps,took dissipation as important,and regarded supportive treatment as inappropriate,therefore surgical operations were always not advocated;LOU’s breast surgical school advocates both dissipation and support,and combined with modern external treatment such as abscess puncture aspiration.In terms of prescription and medicine,LOU’s breast surgical school created LOU’s Rongbing Decoction on the bas

关 键 词：外科证治全生集 王洪绪 楼氏乳科 楼丽华 阴证 阳和汤 温通治痈 肉芽肿性小叶性乳腺炎 

分 类 号：R605[医药卫生—外科学]