张锡纯论治“血枯病”发微  

Zhang Xichun’s treatment of blood depletion disease

作　　者：张馨予 李萌菲 王桂青 陈丽娅 姜苗[1,2] ZHANG Xinyu;LI Mengfei;WANG Guiqing;CHEN Liya;JIANG Miao(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;School of Life Sciences,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学生命科学学院

出　　处：《北京中医药大学学报》2023年第2期176-180,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81973667);北京中医药大学横向发展基金项目(No.2170072220001)。

摘　　要：血枯病源自《黄帝内经》,临床以胸胁胀满、纳食不佳、咳血、便血、尿血为主要表现,甚则女子出现闭经,方用四乌鲗骨一藘茹丸治之。后世医家对血枯病的病因病机、治疗重点、遣方用药众说纷纭,认为四乌鲗骨一藘茹丸中海螵蛸收敛固涩,茜草通经活血,其功效相悖,临床难以把握,以致经典良方险些湮没。及至民国,张锡纯守《黄帝内经》之本,钩沉拾遗,衷中参西,在其代表作《医学衷中参西录》中对血枯病的创新大体可归纳为古病新方、古方新用。一方面,本团队试从古病新方的角度整理了张锡纯为治疗血枯病创制的理冲汤、理冲丸、资生汤、资生通脉汤、醴泉饮、化瘀通经散、十全育真汤等新方,他认为血枯病的病机为心郁脾虚、血分瘀阻,治疗原则为扶正黜邪,以斡旋坤土为基,兼以祛瘀化滞、滋阴降火。另一方面,本团队试从古方新用角度探讨张锡纯打破海螵蛸、茜草药效相悖的局限,利用药对化滞、收涩的双向调节作用,治疗带下病、崩漏、淋病、便血、尿血等,拓宽了古方的适应症。以上两点可为临床治疗妇科、男科等疾病提供新思路。Blood depletion disease originates from Huangdi Neijing.The clinical symptoms are fullness and discomfort in the chest and hypochondrium,poor diet,hemoptysis,blood in the urine,blood in the stool,even in woman with amenorrhea.The Siwuzeigu Yiluru Pill can be used to treat blood depletion disease,although physicians of later generations had different opinions on the etiology,pathogenesis,treatment,and prescription of blood depletion disease.It was even believed that the cuttlefish bone in Siwuzeigu Yiluru Pill has astringent effects,while India madder root is used to promote blood circulation.However,astringent is contrary to the effect of promoting blood circulation,and difficult to grasp clinically,the classic prescription almost disappeared.Zhang Xichun,a famous physician of the Republic of China,inherited the spirit of Huangdi Neijing and integrated traditional Chinese medicine and Western medicine.He provided innovative research on blood depletion disease in his representative work Records of Tradition Chinese and Western Medicine in Combination,which can be roughly summarized into two points as new prescriptions for ancient diseases and new use of ancient herbal prescriptions.Our team attempted to sort the new prescriptions created by Zhang Xichun to treat blood depletion disease,including Lichong Decoction,Lichong Pill,Zisheng Decoction,Zisheng Tongmai Decoction,Liquan Decoction,Huayu Tongjing Powder,and Shiquan Yuzhen Decoction,from the perspective of new prescriptions for ancient diseases.He believed that stagnation of heart and spleen deficiency and blood stasis underlie the pathogenesis of blood depletion disease,and suggested that the most effective treatment would be to strengthen the vital energy and eliminate the pathogenic factor,while concurrently promoting digestion,removing blood stasis and removing stagnation,nourishing yin for reducing fire.However,we also aimed to discuss Zhang Xichun’s idea of removing the limitation of the contradictory efficacy of cuttlefish bone and India madder root in

关 键 词：血枯病 医学衷中参西录 张锡纯 古病新方 古方新用 

分 类 号：R221[医药卫生—中医基础理论]