《扁鹊心书》论治虚劳特色探析  

An analysis of the characteristics of treating consumptive disease in Bianque Xinshu

作　　者：王珍珍 丁瑞丛 杨淼 刘志华[2] WANG Zhenzhen

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450000 [2]河南省中医院,河南郑州450000

出　　处：《中医临床研究》2023年第22期18-22,共5页Clinical Journal Of Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教发[2018]134号);河南省中医药科学研究专项课题(2022ZY1065);河南省中医药科学研究专项课题(20-21ZY2208)。

摘　　要：《扁鹊心书·虚劳篇》是窦材医案中较能体现其辨证思想和特色的一篇,其中“须识扶阳”“当明经络”“大病宜灸”等学术思想对指导虚劳的治疗大有裨益。窦材按虚损程度不同将其分为虚劳与痨瘵,并提出了相应治疗方案,强调了“未病先防,已病防变”的治疗原则,防止虚劳病情进一步发展。窦材标新立异,在“阴虚成劳”论风靡之际,明确提出虚劳病机为脾肾阳虚,虚劳之演变乃自上而下,由肺及脾,由脾及肾。窦材认为虚劳之脉象为弦脉,强调脉象在诊断虚劳的作用,但其临证注重望闻问切、四诊合参、综合辨证。治疗上,他承袭了《黄帝内经》重阳思想,认为阳气是人体生命之源。肾为先天之本,脾为后天之本,因此五脏辨证中窦材尤为重视脾肾,扶持脾肾之阳对现代人治病养生仍有重要意义。窦材用药奉灼艾第一,丹药第二,附子第三,窦材认为“大病宜灸”,虚劳此病病程日久,迁延难愈,容易反复,因此其用灸为先灸、多灸、重灸,补火助阳,使劫得病回。此外,窦材认为还应远离温平药、寒凉转下之品,并注重虚劳之人日常调摄,在日常生活中务必规律饮食、清淡饮食,养成良好的生活习惯,切勿吸烟饮酒,调畅情志,保持心情愉悦。窦材论治虚劳思想应用于现代临床仍效果显著,值得继续深入探讨与应用。In Fatigue of Bianque Xinshu(《扁鹊心书·虚劳篇》),the consummation chapter is one of DOU Cai’s medical cases that can better reflect his differentiation thoughts and characteristics.Among them,academic ideas such as must know Fuyang(扶阳),understand the meridians and moxibustion for serious diseases are great benefit to guide the treatment of fatigue.According to the different degrees of consumptive damage,it can be divided into consumptive disease and tuberculosis.And puting forward the corresponding treatment plan,emphasizing the treatment principle of prevention before disease,prevention of disease and change,to prevent the progression of fatigue.When the theory of Yin(阴)deficiency becomes consumptive disease is popular,DOU Cai breaks the convention and clearly proposes that the mechanism of deficiency is spleen and kidney Yang(阳)deficiency,and the evolution of deficiency is from top to bottom,from the lungs and spleen,from the spleen and kidneys.DOU Cai believes that the veins of consumptive disease are string veins,and emphasizes the role of veins in diagnosing consumptive disease.However,his clinical evidence focuses on looking and hearing and inquiring,combining four diagnoses and references,and comprehensive dialectics.In terms of treatment,he inherited the idea of attaching importance to Yang Qi(气)in Huangdi Neijing(《黄帝内经》),believing that Yang Qi is the source of human life.The kidney is the innate foundation,and the spleen is the acquired foundation,so he pays special attention to the spleen and kidney in the dialectic of the five organs,and supporting the Yang of the spleen and kidney is still of great significance to modern people to treat diseases and maintain health.In terms of medication,moxibustion is the first,medicinal herbs are second,and Fuzi(Radix Aconiti Lateralis Preparata)is the third.DOU Cai believes that serious diseases should be moxibustion,and the course of this disease is long,prolonged,and easy to repeat.Therefore,he used moxibustion as the first moxi

关 键 词：《扁鹊心书》 虚劳 辨证论治 

分 类 号：R255.5[医药卫生—中医内科学]