基于虚劳探究叶天士对经方的继承与创新  

Exploration of Ye Tianshi’s inheritance and innovation of classic formulas based on consumptive diseases

作　　者：叶冠成 张泽涵 杨志然 黄小娟 王凤龙 苗瑞恒 赵歆[2] YE Guancheng;ZHANG Zehan;YANG Zhiran;HUANG Xiaojuan;WANG Fenglong;MIAO Ruiheng;ZHAO Xin(Second Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100078;Beijing University of Chinese Medicine;Department of Iradilional Chinese Medicine,Huangshan People's Hospital;Department of Acupuncture,Beijing Shijitan Hospital Affiliated to Capital Medical University)

机构地区：[1]北京中医药大学第二临床医学院,北京100078 [2]北京中医药大学 [3]黄山市人民医院中医科 [4]首都医科大学附属北京世纪坛医院

出　　处：《现代中医临床》2022年第1期34-38,共5页Modern Chinese Clinical Medicine

基　　金：国家重点研发计划资助项目(No.2017YFC1702402)。

摘　　要：虚劳是一种由外感、内伤、七情过度所诱发,以脏腑亏损、气血阴阳俱损为基本病机的慢性虚损性疾病,也可作为症状出现在诸多疾病中。叶天士对于各类杂病治疗造诣颇深,尤善治虚劳。《临证指南医案》是叶氏学术思想的集中体现,其中虚劳医案较多,也独具特色。通过阅读《临证指南医案》医案,探讨叶氏经方特色。叶氏论治虚劳的理论特色包括:建中培元,调和营卫;胃有阴阳,分证论治;脾肾双补,中下兼顾。叶氏经方应用特色包括:善用食疗,胃喜为补;血肉有情,补肾填精;用药清灵,柔阳滋液;甘寒濡润,保阴养正;共调气机,升降相因;久病入络,化瘀散结。Deficiency in traditional Chinese medicine refers to a series of chronic debilitating diseases induced by exogenous pathogenic factors,internal injuries,and excessive seven emotions.The basic pathogenesis is loss of viscera and qi,blood,yin and yang.It can also appear as a symptom in many diseases.Ye Tianshi had deep insights in the treatment of various miscellaneous diseases,especially in treating consumptive diseases.The Clinical Guide to Medical Records is a concentrated expression of Ye’s academic thoughts.Among them,there have been many medical records about insufficiency,with distinctive features.We explored the characteristics of Ye’s classic prescriptions by reading the medical records of The Clinical Guide to Medical Records.The theoretical characteristics of Ye’s theory on the treatment of asthenia included fortifying the middle and promoting the yuan,regulating and harmonizing yin and wei;The stomach(disease)has both yin and yang,thus its treatment should be based on the pattern identification;The spleen and the kidney should be both tonified with an eye to the middle and the lower energizers.The application features of Ye’s classic formulas included good use of dietary therapy;nourishing the kidney and essence;medication for clearing spirits,emolliating yang and nourishing liquid;protecting yin and nourishing healthy qi;co-regulating qi movements;removing blood stasis and dispelling congestion,as chronic illnesses may affect the collaterals.

关 键 词：虚劳 叶天士 《临证指南医案》 临证特色 

分 类 号：R249.2[医药卫生—中医临床基础]