《醉花窗医案》杂病辨治特色探析  

Analysis on the Characteristics of Differentiation and Treatment of Miscellaneous Diseases in Medical Record of Zuihuachuang

作　　者：蔡泳源 李雪莹 牛天福[1] 李奕祺[3] CAI Yongyuan;LI Xueying;NIU Tianfu(Shanxi Academy of Traditional Chinese Medicine,Taiyuan(030012),China;The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine)

机构地区：[1]山西省中医药研究院,太原030012 [2]福建中医药大学附属人民医院 [3]福建中医药大学中医学院

出　　处：《浙江中医药大学学报》2023年第3期312-316,共5页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]探究《醉花窗医案》中王堉对各类杂病的辨治思想和特色,为中医临床诊疗提供参考。[方法]对《醉花窗医案》全文所列医案、医论、地方水土论、药材论、简方验方论等内容进行归类分析,并结合其他相关古籍,系统总结王堉的学术思想和杂病辨治特色。[结果]《醉花窗医案》为山西著名医家王堉所著,共收集101案,内容精巧、深刻广泛。王堉立足天人合一,精于脉症,辨证准确,主次分明;认为脾胃健运为摄生之本,当以调胃为先、补脾为重、化痰清热为变;又兼顾肝肾,以“清泄肝热、活血舒郁、益阴养血”次第疗法治肝郁杂病,以“滋水制火”解内伤阴热;并善从三焦气化治疗诸类水湿痰饮杂病;又活用古方验方,与道地药材互补加减。[结论]王堉在辨治各类杂病方面独具特色,尊古而不拘泥,思维严谨,辨证用药精准有序,能为现代中医临床治疗各类杂病开拓新的思路,具有重要的学习和临床诊疗参考价值。[Objective]To explore the differentiation and treatment ideas and characteristics of various miscellaneous diseases in WANG Yu's Medical Record of Zuihuachuang,so as to provide reference for clinical diagnosis and treatment of traditional Chinese medicine.[Methods]Classify and analyze the medical cases,medical theories,local water and soil theories,medicinal materials theories,simple prescriptions and empirical prescriptions listed in the full text of Medical Record of Zuihuachuang,and systematically summarize WANG Yu's academic thoughts and the characteristics of syndrome differentiation and treatment of miscellaneous diseases in combination with other relevant ancient books.[Results]The Medical Record of Zuihuachuang was written by WANG Yu,a famous doctor in Shanxi Province,which collected 101 cases in total,and the content was exquisite,profound and extensive.Based on the unity of heaven and man,WANG Yu was proficient in pulse syndrome,accurate in syndrome differentiation and clear in primary and secondary;he believed that the health of the spleen and stomach was the foundation of health,and treatment should focus on regulating the stomach first,tonifying the spleen was the most important,resolving phlegm and clearing away heat was the change;WANG Yu also took into account the liver and kidney,and treated liver depression and miscellaneous diseases with the secondary therapy of“clearing liver heat,activating blood circulation and relieving depression,and benefiting Yin and nourishing blood”,and solved internal injury Yin heat with“nourishing Yin and purging fire”;and was good at gasification from tri-Jiao to treat all kinds of miscellaneous diseases of water dampness and phlegm;WANG Yu also made use of ancient prescriptions,complementing and subtracting with genuine medicinal materials.[Conclusion]WANG Yu was unique in the treatment of various miscellaneous diseases.He respected the ancient but not rigidly,had rigorous thinking,accurate and orderly syndrome differentiation and medication,and opened up

关 键 词：醉花窗医案 王堉 杂病 脾胃 肝肾 三焦 辨治特色 

分 类 号：R249[医药卫生—中医临床基础]