薛汉荣教授运用代赭石治疗肺病喘咳的临床经验探讨  

Professor XUE Hanrong’s clinical experience in treating dyspnea and cough in lung with Daizheshi

作　　者：查军 袁欣 薛汉荣[2] ZHA Jun

机构地区：[1]江西中医药大学,江西南昌330006 [2]江西中医药大学附属医院,江西南昌330006

出　　处：《中医临床研究》2024年第8期33-38,共6页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金项目(81960802)。

摘　　要：薛汉荣教授师从国医大师洪广祥教授,在从医多年间积累了丰富的临床经验,特别是在治疗肺系疾病方面有独特的临床见解与感悟,文章在此对薛汉荣教授运用代赭石治疗肺病喘咳的临床经验做了初步探析与总结,以飨同道。文章涉及的证型全面广泛,其中包括虚性喘咳、虚实夹杂性喘咳及实性喘咳三种,喘咳主要涉及的脏腑有肺、肾、胃及肝脏,虚性喘咳的病位以肺肾为主,其中肾虚又包括肾阴、肾阳以及肾气亏虚所致喘咳,肺虚者以气虚为主。对于虚实夹杂者,重点强调胃虚痰阻型以及肝阳上亢型,分别以旋覆代赭汤和镇肝熄风汤为代表方联合代赭石加味进行治疗,代赭石作用多样,依据配伍方药的君、臣、佐、使的不同而变化,所以在这两个经典方剂中作用的侧重点各有不同。对于实喘者,薛汉荣教授多强调治痰的重要性,代赭石下气、降痰,联合疏肝调肝法,一升一降使肝肺升降气机之枢纽调达,气机调和,气血津液调畅,则痰瘀之病理产物得消,喘咳自解。喘咳之证诸多,涉及的脏腑也非独有肺脏,重点是有效利用代赭石降肺胃上逆之气,善泻有余之火,质重向下引药达病所,平肝潜阳、降痰邪的特性,再按患者病情需要有目的地将不同药物进行组合配伍来增强原有疗效、提高主药疗效以及避免药物的不良反应。Professor XUE Hanrong studied under Professor HONG Guangxiang,a master of traditional Chinese medicine.Professor XUE Hanrong has accumulated rich clinical experience in the treatment of lung diseases,especially in the treatment of lung diseases.This paper makes a preliminary analysis and summary of Professor XUE Hanrong’s clinical experience in the treatment of asthma and cough in lung diseases with Daizheshi(Haematitum).The syndrome types involved in this paper are comprehensive and extensive,including deficiency asthma cough,deficiency and excess mixed asthma cough and solid asthma cough.The main internal organs involved in asthma cough are lung,kidney,stomach and liver.The disease location of deficiency asthma cough is mainly lung and kidney,among which kidney deficiency includes kidney Yin(阴),kidney Yang(阳)and kidney Qi(气)deficiency.The inclusion of deficiency and excess focuses on stomach deficiency and phlegm obstruction type and liver Yang hyperactivity type.The Xuanfu Daizhe decoction(旋覆代赭汤)and the Zhen’gan Xifeng decoction(镇肝熄风汤)are respectively used as representative prescriptions combined with Daizheshi for treatment.The role of Daizheshi is diverse according to the compatibility of prescriptions.The monarch,minister,assistant and messenger are various,so the focuses of the roles of Daizheshi in these two classic prescriptions are different.For asthmatic patients,Professor XUE Hanrong emphasized the importance of treating phlegm.Daizheshi can lower Qi(气)and reduce phlegm,combined with the method of soothing liver and regulating liver.The function of one rise and another fall of the two can regulate the harmonizing of lifting and lowering of Qi movement of the hub,namely the liver and lung.When Qi is harmonized,and Qi,blood and body fluid are regulated,phlegm and blood stasis and other pathological products are eliminated,and dyspnea and cough are relieved by themselves.There are many syndromes of asthma and cough,and the viscera involved are not unique to the lungs.The f

关 键 词：代赭石 喘咳 临床经验 

分 类 号：R256.12[医药卫生—中医内科学]