从气机升降探叶天士调治便秘六法  

Analysis of YE Tianshi’s Six Methods of Regulating Constipation from Regulating Qi Movement

作　　者：夏婷婷[1] 郑文丽 江昊翼 王颖[1] XIA Tingting;ZHENG Wenli;JIANG Haoyi(Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学,杭州310053

出　　处：《浙江中医药大学学报》2022年第1期97-100,共4页Journal of Zhejiang Chinese Medical University

基　　金：浙江中医药大学校级研究生科学研究基金项目(2021YKJ23)。

摘　　要：[目的]从气机升降角度探讨叶天士治疗便秘的特色。[方法]通过学习《临证指南医案》中便秘的相关论述及医案,总结叶天士医案中便秘的病因病机特点,阐述叶天士辨治便秘的遣方用药独特之处,并附以验案一例以示临床应用。[结果]《临证指南医案》一书中,叶天士将便秘的重要病因病机归于脏腑气机失常:即肺失宣降、肝失疏泄、三焦不畅、气血结痹、阴虚阳亢及胃失和降,与此相对应的治疗方法为开降肺气、疏泄肝气、宣通三焦、双通气血、潜阳固阴及和降胃气六法。所附验案以叶天士脏腑气机升降学说为指导,采用疏利肝胆、宣肺通腑、活血通络之法治疗便秘,临床疗效确切。[结论]通过调畅全身脏腑气机治疗便秘是叶天士治疗便秘的特色,值得深入学习及挖掘。[Objective] To analyze YE Tianshi’s strategy in treating constipation by regulating Qi movement. [Methods] Through studying the interrelated thesis and medical cases about constipation in A Guide to Clinical Practice with Medical Records, this paper summarized the etiology and pathogenesis characteristics of constipation in YE Tianshi’s medical cases, expounded the unique features of prescription and medication of YE Tianshi in treating constipation, and a case was attached to show the clinical application. [Results] In A Guide to Clinical Practice with Medical Records, the disordered Qi movement in viscera was thought to be the vital etiology and pathogenesis of constipation, including the failure of the lung in dispersing and descending, failure of the liver in soothing, failure of tri-Jiao in dispersing and opening, Qi and blood stagnation, Yin deficiency and Yang hyperactivity, and failure of the stomach in descending. And the main treatment methods included six methods of diffusing and descending the lung Qi, soothing the liver Qi, dispersing and opening tri-Jiao,dredging Qi and blood, suppressing Yang and consolidating Yin and descending the stomach Qi. The attached medical record was guided by the theory of Qi movement in viscera and the methods of dispersing stagnated liver Qi and promoting bile flow, diffusing lung Qi and descending viscera, promoting blood circulation and dredging collaterals were used to treat constipation which with definite clinical effect.[Conclusion] It is YE Tianshi’s characteristic to treat constipation by regulating viscera Qi movement, which is worthy of in further study and excavation.

关 键 词：叶天士 临证指南医案 便秘 气机 肝失疏泄 肺失宣降 胃失和降 三焦不畅 

分 类 号：R574[医药卫生—消化系统]