张锡纯辨治眩晕学术思想探析  

Analysis of Zhang Xichun’s academic thoughts on the treatment of vertigo

作　　者：孙兴甲 王洋[1] 王卉 刘坤[1] SUN Xingjia;WANG Yang;WANG Hui;LIU Kun(Department of General,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院综合科,北京100053

出　　处：《中国医药导报》2023年第36期142-146,150,共6页China Medical Herald

基　　金：北京中医药科技发展资金项目(JJ2018-91);中国中医科学院广安门医院结余经费课题(2022023)。

摘　　要：眩晕是常见的临床症状之一,可见于多种疾病。张锡纯立足于历代医家的观点,汲取总结前人经验,并对眩晕的认识和治疗提出了新的思路,本文基于《医学衷中参西录》探讨张锡纯治疗眩晕学术特色,发现其论治眩晕,病因上多从虚实入手,虚证分为气虚、血虚和阴虚致眩,实证多由外感风寒和痰湿导致,病位与肝密切相关,病机涉及冲气上冲、火不归原,治疗上用药考究药性,善用寒、补、敛、降等药物,方剂上多有创新,创制镇肝熄风汤、建瓴汤、理痰汤等治疗眩晕,反对盲目运用补阳还五汤。张锡纯丰富了眩晕的诊疗方法,形成了完备的思想体系,推动了眩晕学术思想的争鸣和发展,对现代眩晕的治疗具有极其重要的指导意义。Vertigo is one of the common clinical symptoms and can be seen in many diseases.Zhang Xichun,based on the viewpoint of doctors in the past dynasties,learned and summarized the experience of predecessors,and put forward new ideas for the understanding and treatment of vertigo.Based on Records of Chinese Medicine with Reference to Western Medicine,this paper discusses Zhang Xichun’s academic characteristics in the treatment of vertigo.It is found that the etiology of Zhang Xichun’s treatment of vertigo starts from excess and deficiency,and deficiency syndrome is divided into qi-deficiency,blood-deficiency,and yin deficiency leading to vertigo.The excess syndrome are mostly caused by exogenous wind-cold and phlegm-dampness,the disease location is closely related to the liver,the pathogenesis involves the up-rushing of qi and the non-return of fire.Treatment of drugs to study drug properties,make good use of cold,tonifying,convergence,sedimentation,and other drugs.There are many innovations in the prescription,the creation of Zhengan Xifeng Decoction,Jianling Decoction,Litan Decoction,and other treatment of vertigo,against the blind use of Buyang Huanwu Decoction.Zhang Xichun enriched the diagnosis and treatment methods of vertigo,formed a complete ideological system,promoted the contention and development of the academic thought of vertigo.His academic ideas have important guiding significance for the treatment of vertigo today.

关 键 词：眩晕 张锡纯 病因病机 诊疗特点 方药特色 

分 类 号：R255.3[医药卫生—中医内科学]