从五脏苦欲补泻理论浅析叶天士治疗肝风经验  

An Analysis of Ye Tianshi's Experience of Treating Liver Wind Based on the Theory of Tonifying and Reducing the Five Zang-Organs

作　　者：陈小梅 鲁玉辉[1] CHEN Xiaomei;LU Yuhui(Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,China,350122)

机构地区：[1]福建中医药大学,福建福州350122

出　　处：《河南中医》2024年第6期857-860,共4页Henan Traditional Chinese Medicine

摘　　要：五脏苦欲补泻理论中,遂从本脏之所欲,顺其性而治者为补;逆从本脏之所喜,反其性而治者为泻,每一味药物均有补泻两方面。叶天士认为,肝风为“身中阳气之变动”,遵“肝苦急,急食甘以缓之”的治疗原则,总结出治肝三法:甘缓法、辛散法、酸泻法。肝体亏虚、肝血不足所致肝风,采用甘酸柔肝法以缓肝,药用芍药甘草汤、何首乌、枸杞子等;胃中空虚所致肝风,采用清养阳明法以缓肝,药用甘麦大枣汤;肝肾亏虚,阳亢不潜所致肝风,采用甘缓潜摄法以缓肝,药用地黄饮子化裁、虎潜丸、牡蛎、六味地黄丸、桑螵蛸等;情志困扰、忧思劳神所致肝风,采用辛甘化风法以补肝,药用当归身、枸杞子、桂圆肉等;肝木气郁化火所致肝风,采用酸敛法以泻肝,药用乌梅、白芍、黄柏、黄连等。Based on the theory of tonifying and reducing the five zang-organs,tonifying is based on the desires of the original organ and treating it according to its nature;while reducing is against the preferences of the original organ and treating it against its nature.Each drug has two aspects:tonifying and reducing.The liver wind is"the change of yang qi in the body".Ye Tianshi followed the treatment principle that"The liver suffers from rapid flow of qi which can be relieved by sweet flavor",and summarized three methods for treating the liver:relieving the liver with sweet,dispersing the liver with pungent,and purging the liver with sour.For liver wind caused by liver deficiency and liver blood insufficiency,method of softening the liver with sweet-sour is adopted,Peony and Licorice Decoction,Heshouwu(Radix Polygoni Multiflori),Gouqizi(Fructus Lycii),etc.can be used;For liver wind caused by emptiness and deficiency of stomach,the method of clearing and nourishing yang brightness is adopted to relieve the liver,so Licorice and Wheat and Jujube Decoction can be used;For liver wind caused by liver and kidney deficiency and yang hyperactivity,the method of subduing with sweet is adopted,so Modified Rehmannia Drink,Hidden Tiger Pill,Six-Ingredient Rehmannia Pill,Muli(Concha Ostreae),Sangpiaoxiao(O theca Mantidis),etc.can be used;For liver wind caused by emotional distress and excessive worry,the method of dispersing with pungent and sweet is adopted,so Danggui(Radix Angelicae Sinensis),Gouqizi(Fructus Lycii),Guiyuanrou(Arillus Longan),etc;can be used.For liver wind caused by liver fire due to qi stagnation,the method of purging the liver fire with sour is adopted,so Wumei(Fructus Mume),Baishao(Radix Paeoniae Alba),Huangbai(Cortex Phellodendri Chinensis),Huanglian(Rhizoma Coptidis),etc.can be used.

关 键 词：肝风 五脏苦欲补泻理论 叶天士 甘酸柔肝法 清养阳明法 甘缓潜摄法 辛散法 酸泻法 

分 类 号：R256.49[医药卫生—中医内科学]