范冠杰运用“三仁汤”治疗湿温病的临床辨治思路  

Thoughts for the Treatment of Damp-warm Disease with Sanren Decoction by FAN Guan-Jie

作　　者：张锦明[1] 田滢舟[1] 张鹏[1] 王丘平[1] 温建炫[1] 吴露露[1] 宋薇[1] 赵玲[1] 范冠杰(指导)[1] ZHANG Jin-Ming;TIAN Ying-Zhou;ZHANG Peng;WANG Qiu-Ping;WEN Jian-Xuan;WU Lu-Lu;SONG Wei;ZHAO Ling;FAN Guan-Jie(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二附属医院,广东省中医院,广东广州510120

出　　处：《广州中医药大学学报》2022年第3期679-682,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医院中医药科学技术研究专项(编号:YN2014WB02);广东省中医药科技创新平台建设项目(编号:2018KT1068);吕仁和广东省中医院名中医药专家学术经验传承工作室建设项目;范冠杰广东省名中医传承工作室建设项目。

摘　　要：总结范冠杰教授运用“三仁汤”治疗湿温病的临床经验。范冠杰教授在运用“三仁汤”辨治湿温病时,提出分析核心病机以确定核心证素,灵活遣方用药、动态因“候”辨治的临床辨治思路。“三仁汤”治疗湿温病的核心病机是“太阴脾虚,湿热蕴结,外感湿热邪气”,其对应的核心证素为“口干不欲多饮,纳食不多,头重如裹,昏蒙眩晕,脘腹胀满,身体困重,大便黏腻不爽,舌苔白腻或黄腻”。临证时若疾病存在湿热邪实内蕴的核心证素,均可灵活使用“三仁汤”,只要动态辨别“湿”与“热”的孰轻孰重,做到因“候”施药,则可提高临床疗效。The clinical experience of Professor FAN Guan-Jie in treating damp-warm disease with Sanren Decoction(Three-Seed Decoction) was summarized. For the treatment of damp-warm disease with Sanren Decoction,Professor FAN Guan-Jie suggested that the core pathogenesis should be analyzed firstly to define the core syndrome elements,and the flexible medication of the prescription should be based on the differentiation of dynamic syndrome manifestations. The core pathogenesis of Sanren Decoction indicated for damp-warm disease can be summarized as Taiyin spleen deficiency resulting into the accumulation of damp-heat and external attack of damp-heat pathogens. The core syndrome elements of the indications of Sanren Decoction are manifested as dryness sensation in the mouth but unwilling to drink much water,poor appetite,swathing sensation of head,abdominal distention and fullness,heaviness of the body,unsmoothly defecation with loose stool,and whitegreasy tongue fur or yellow-greasy tongue fur. In the clinic,once the patients have the core syndrome elements of internal accumulation of excessive damp-heat, Sanren Decoction can be applied for the treatment flexibly.Satisfactory efficacy will be achieved if the predominance of dampness and heat has been determined and the medication follows the dynamic syndrome manifestations.

关 键 词：三仁汤 湿温病 太阴脾虚 湿热蕴结 范冠杰 

分 类 号：R254.2[医药卫生—中医内科学]