《金匮要略》痰饮病探微  

Exploration of Phlegm-Fluid Retention Diseases in Synopsis of the Golden Chamber

作　　者：张淑香[1] 党辉[1] 孙士玲[1] ZHANG Shuxiang;DANG Hui;SUN Shiling(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450001)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450001

出　　处：《河南中医》2024年第8期1135-1139,共5页Henan Traditional Chinese Medicine

摘　　要：痰饮病为张仲景首创,症状多样,饮因于湿,在肺则咳,在胸则痞,在胃则呕,在胁则胀,在肠则泻,在肌肤则肿,在四肢经络则痹,弦脉为其主脉,临床中凡新病脉衰者为难治,久病脉盛者多不治。其总属本虚标实之证,病程日久,常有寒热虚实之间的相互转化,且饮积可生痰,痰瘀互结,病情更加缠绵,若肾虚开阖不利,更可出现凌心、射肺等重证。治疗以“病痰饮者,当以温药和之”为总则,气和则化,气偏则结,借温热以伸其阳,痰饮阴邪则得祛也。可从痰饮病脉、痰饮病症、痰饮病方、痰饮病与水气病四个方面全面把握,根据标本虚实,表里寒热,脉证合参,分别采用温化、发汗、利小便、助水等法治疗。Phlegm-fluid retention disease was first created by Zhang Zhongjing,with various symptoms.Fluid retention is caused by dampness,leading to coughing in the lung,stuffiness in the chest,nausea in the stomach,bloating in the ribs,diarrhea in the intestines,swelling in the skin,and obstruction of the meridians in the limbs.The main pulse is wiry pulse.In clinical practice,it is difficult to treat new diseases with weak pulse,and those with long-term diseases with excessive pulse are often not treatable.Generally speaking,it belongs to the syndrome of deficient root cause and excessive manifestation.With a long course of disease,there is often a mutual transformation between cold,heat,deficiency,and excess.Fluid accumulation can produce phlegm,then phlegm and blood stasis can combine,making the condition more lingering.If kidney deficiency is not conducive to opening and closing,it can also lead to severe symptoms such as attacking the heart and lung.The general principle of treatment is"for those with phlegm-fluid retention diseases,warm medicine should be used to harmonize them".When qi is harmonious,it will dissolve phlegm retention,and when qi is deviated,it will become stagnant.By using warmth to promote yang,phlegm-fluid retention and yin pathogen can be eliminated.It is necessary to comprehensively grasp the four aspects:phlegm-fluid retention disease pulse,phlegm-fluid retention disease symptom,phlegm-fluid retention disease formula,and edema.Based on the deficiency and excess of the syndrome of deficient root cause and excessive manifestation,the exterior and interior,cold and heat,the combination of pulse and syndrome,methods such as warming,resolving,sweating,promoting diuresis,and draining dampness should be used for treatment.

关 键 词：痰饮病 痰饮病脉 痰饮病症 痰饮病方 水气病 《金匮要略》 张仲景 

分 类 号：R222.3[医药卫生—中医基础理论]