五运六气学说指导下血府逐瘀汤的临床新用  

The new clinical use of the Xuefu Zhuyu decoction under the guidance of the five evolutive phases and six climatic factors theory

作　　者：李嘉慧 张斌霞[2] 李昕玥 常光灿 LI Jiahui

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属常州市中医医院,江苏常州213000

出　　处：《中医临床研究》2024年第7期45-48,共4页Clinical Journal Of Chinese Medicine

基　　金：国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医人教函【2019】62号);江苏省研究生培养创新工程实践创新计划项目(SJCX22-0872)。

摘　　要：血府逐瘀汤出自于清代医家王清任的《医林改错》,原文记载此方主治症目众多,可达19种。历代医家仅意识到血府逐瘀汤是一张活血良方,认为此方可治疗众多疾病的缘由是因其具有活血化瘀、行气止痛之效,并未从其它角度进行解释阐发。张斌霞教授师从于运气大医顾植山教授,其临床诊疗多在五运六气学说指导下进行多维诊治,常从六经病欲解时和开阖枢理论的角度灵活运用血府逐瘀汤治疗各类疾病,扩大了临床治疗范围且大幅提高了治疗效果,充分展现此方的临床新用,证明了血府逐瘀汤不仅为活血良方,更为治疗少阴少阳转枢不利、少阳病欲解时相关疾病之良方。文章将从古今医家对血府逐瘀汤认识及应用,五运六气学说及其指导下的开阖枢理论和六经病欲解时理论,临床应用举隅等方面进行详细论证,在丰富众多学者对血府逐瘀汤的认识的同时,进一步加强对五运六气学说的了解,以期为临床辨证提供新的思路和方法,为中医药事业的传承发展与创新做出贡献。The Xuefu Zhuyu decoction(血府逐瘀汤)comes from the book Yilin Gaicuo(《医林改错》)by WANG Qingren,a doctor in the Qing dynasty.The original text recorded that the indications were numerous,a total of 19 species.The medical practitioners over the ages only realized that the Xuefu Zhuyu decoction was a good formula to invigorate blood circulation,andT believed that the reason for its ability to treat many diseases was because it had the effects of invigorating blood circulation,removing blood stasis,moving Qi(气)and relieving pain.Professor GU Zhishan,a greater doctor,is guided by the five evolutive phases and six climatic factors doctrines to treat diseases in a multi-dimensional way in clinical practice.The Xuefu Zhuyu decoction is often used flexibly to treat various diseases from the perspective of the six meridians and the theory of opening and closing pivot,which expands the scope of clinical treatment and greatly improves the treatment effect,fully demonstrating the new clinical use of this formula,proving that the Xuefu Zhuyu decoction is not only a good formula for invigorating the blood,but also a good formula on diseases related to Shaoyin(少阴)and Shaoyang(少阳)pivot dysfunction and critical time for recovery of Shaoyang diseases.In this article,we will discuss the prescription in detail from aspects of the understanding and application of the Xuefu Zhuyu decoction by ancient and modern medical practitioners,the theory of the five evolutive phases and six climatic factors and the theory of the opening and closing pivot,and the theory of six meridians disease tending to be resolved,as well as examples of clinical applications.It is hoped to enrich the understanding of doctors on the Xuefu Zhuyu decoction and further strengthen the understanding on the theory of five evolutive phases and six climatic factors,so as to provide new ideas and methods for clinical syndrome differentiation,and make contributions to the inheritance,development and innovation of TCM.

关 键 词：血府逐瘀汤 五运六气 开阖枢理论 六经病欲解时 临床应用 

分 类 号：R289.5[医药卫生—方剂学]