叶天士对薛己朝夕补法的继承与发展  

Ye Tianshi’s inheritance and development of Xue Ji’s Morning-and-Evening Supplementing Method

作　　者：赵云帆 连雅君 沈晓倩 孙晓光[1] ZHAO Yunfan;LIAN Yajun;SHEN Xiaoqian;SUN Xiaoguang(Beijing University of Chinese Medicine,Beijing 100029;Nanjing University of Chinese Medicine)

机构地区：[1]北京中医药大学,北京100029 [2]南京中医药大学

出　　处：《现代中医临床》2023年第5期64-68,共5页Modern Chinese Clinical Medicine

基　　金：国家重点研发计划项目资助(No.2018YFC1704100,No.2018YFC1704101);国家中医药管理局—燕京刘氏伤寒流派传承工作室第二轮建设项目(国中医药办人教函[2019]62号)。

摘　　要：朝夕补法为明代医家薛己所创,是以补脾与补肾之剂朝夕分而服之治疗疾病的方法。叶天士对此法继承并发展,形成了有叶氏特色的分治法。本文以《临证指南医案》一书为研究对象,筛选出叶天士分治法医案共57则进行分析研究,探讨叶天士分治法对薛己的朝夕补法的继承与发展关系。叶天士在薛氏基础上的发挥主要体现在四方面:补肾升阳,发挥顺时补法;胃肾分治,不局限于太阴;重视阴液,发挥逆时补法;阴枯不纳,提出滋润之法。叶天士的创新主要体现在时间上不拘于朝夕;治法上不拘于温补,多种治法兼施。The Morning-and-Evening Supplementing Method,created by Xue Ji,a physician of the Ming Dynasty,is an approach of treating diseases by taking different medications,which serves to supplement the spleen or the kidney,in the morning and evening.Ye Tianshi inherited and evolved this method into a way of treatment with his own characteristics.This paper selects 57 medical records representing Ye’s version of the Morning-and-Evening Supplementing Method from his Lin Zheng Zhi Nan Yi An(Case Records as a Guide to Clinical Practice)to investigate his contributions to the development of this theory.It was found that,building on what Xue had proposed,Ye further put forward four new ideas:1.supplementing the kidney and raising yang in tune with the time of day;2.separate treatment of the stomach and kidney,not limited to taiyin;3.supplementing yin fluids against the time of day;4.nourishing and moistening for inability to receive of the spleen and stomach due to withered yin.In a nutshell,Ye’s innovation is mainly reflected in the fact that the time for taking medications was no longer limited to the morning and evening,and also in the multiple treatment method he added building on the warming and tonifying method Xue advocated.

关 键 词：叶天士 薛己 临证指南医案 朝夕补法 

分 类 号：R2-09[医药卫生—中医学]