蔡淦从脾胃治疗内伤疾病经验  

Cai Gan′s Experience of Treating Internal Injury Diseases from Spleen and Stomach

作　　者：张正利[1] 蔡淦 丛军 ZHANG Zheng-li;CAI Gan;CONG Jun(Shuguang Hospital Afriliated to Shanghai University of Traditional Chinese Medicine,Shanghai,China,200021;Cai Gan Studio of National Famous Traditional Chinese Medicine Doctor,Shanghai,China,200021)

机构地区：[1]上海中医药大学附属曙光医院,上海200021 [2]全国名中医蔡淦工作室,上海200021

出　　处：《河南中医》2023年第1期24-27,共4页Henan Traditional Chinese Medicine

基　　金：上海中医药发展办公室全国名中医工作室建设项目(MZYGZS-2017003)。

摘　　要：脾胃治中央,兼四气,脏腑气血阴阳皆禀气于脾胃,若脾胃功能失常,营卫不和,清浊相干,就会发生多种内伤疾病。蔡淦教授治疗内伤疾病,时时注意顾护脾胃。脾胃亏虚,肺卫失养,表卫不固之证,予六君子汤合玉屏风散加减;脾胃虚弱,荣卫俱不足者,予四君子汤合黄芪建中汤;久病脾胃亏虚,兼见外感后痰嗽久延不愈,或外感日久,正气亏耗,脾肺俱虚者,用六君子汤作为基础方加减治疗。心主血,血藏神,脾主运化,主思,心与脾胃,母病及子,子病及母,往往形成心脾两虚证。心脾不足,营血亏虚者,用归脾丸加减治疗;心气不足者用妙香散加减;气血不足,兼有痰浊内扰者,则用十味温胆汤加减治疗。肝主疏泄,主升发,肝气易动而化火,脾胃属土,主运化,其气冲和。木本克土,但脾气强,对易动之肝气有反制作用,对于肝脾不和者,蔡淦教授用小建中汤加减治疗;肝郁脾虚明显者,予柴芍六君子汤加减,或补中益气汤加防风、桂枝、羌活等;肝郁脾虚,兼有肝血亏虚者,用逍遥散治疗。补肾需重视脾胃,且补肾之药,大多滋腻重沉,难于消化,补脾胃之药有助运化作用。肾虚症状较轻,且肾之阴阳虚损不典型者,常选用香砂六君子汤加菟丝子、沙苑子、杜仲、川续断、桑寄生、怀牛膝等温和补肾药物,如脾胃虚寒明显,用理中汤和四神丸加减;脾肾阴亏者,用参苓白术散合水陆二仙丹加减化裁;阴虚明显者,加乌梅、山茱萸、熟地黄、枸杞子、覆盆子等。Spleen and stomach to treat the central, and four qi,Qi and blood Yin and Yang of the viscera are abundant in the spleen and stomach, if the spleen and stomach function is abnormal, with disharmony between nutrient and defense qi,mutual disturbance of clarity and turbidity, a variety of internal injury diseases will occur.He always pays attention to protecting the spleen and stomach when treating internal injury diseases.For the syndrome of spleen and stomach deficiency, loss of nourishment of lung defense qi,insecurity of defense qi,Six Gentlemen Decoction combined with Modified Jade Wind-Barrier Powder can be used.For those with weak spleen and stomach and insufficient defense qi,Four Gentlemen Decoction combined with Modified Astragalus Center-Fortifying Decoction can be used.For those who suffer from chronic spleen-stomach deficiency, and long-time phlegm cough due to external contraction, or insufficient healthy qi,spleen-lung deficiency due to long-time external contraction, Six Gentlemen Decoction can be given as the basic treatment for modification.The heart controls blood circulation, and blood houses the mind;The spleen governs transportation and transformation and controls pensiveness.For the heart and spleen and stomach, mother diseases and child disease affect each other, often form the syndrome of heart-spleen deficiency.For those with heart-spleen insufficiency and deficiency of nutrient blood, Modified Spleen-Restoring Decoction can be used.For insufficient heart qi,Modified Mysterious Fragrance Powder can be used.For those with insufficient qi and blood and internal disturbance caused by turbid phlegm, Modified Ten-Ingredient Gallbladder-Warming Decoction can be used.The liver governs free flow of qi.The liver qi is easy to move and turn into fire.The spleen and stomach belong to the earth, govern transportation and transformation.Wood originally restrains earth, but strong spleen qi has a counter effect on the volatile liver qi.For those with disharmony between the liver and spleen, Professor Ca

关 键 词：内伤疾病 从脾胃治疗 蔡淦 

分 类 号：R255[医药卫生—中医内科学]