《证治汇补》水肿诊疗理论框架研究  

Study on the Theoretical Framework of Diagnosis and Treatment of Edema in Evidence and Treatment Supplement

作　　者：吕晓明[1] 尚冰[1] 傅海燕[1] LYU Xiaoming;SHANG Bing;FU Haiyan(Liaoning University of Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《辽宁中医药大学学报》2024年第10期69-73,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2013CB532004);辽宁省科技计划联合计划基金-博士科研启动项目(2023-BSBA-227);辽宁省教育厅高校基本科研项目(JYTQN2023475)。

摘　　要：《证治汇补》是由清代李用粹撰于康熙二十六年,其对水肿病的认识非常丰富,具有较高的临床价值。文章通过系统分析其对水肿病的因机证治理论,构建《证治汇补》水肿诊疗理论框架。言明水肿病由诸湿肿满皆属于脾、肾虚水泛渗于皮肤,肺失通调水液停聚所致,同时肺肾相传。其辨治当分清阳水阴水、气肿水肿、风肿瘀肿、风水石水、水分血分等类型,注重喘胀相因、水肿脉法和水肿死症。以“调中健脾”为治疗大法,治分阴阳、治分汗渗、湿热宜清、寒湿宜温、阴虚宜补,邪实当攻。四苓散加味为主方,同时依据病情加减用药。成方亦选用金匮肾气丸、术附汤、地黄汤加味、椒仁丸和牵牛甘遂加味。外治法以商陆根加麝香、蝼蛄、田螺、大蒜、车前草等外敷。预防调护包括忌甘温药、戒针刺、绝酒色、却盐酱、戒忿怒。并根据上述内容绘制《证治汇补》水肿诊疗理论框架图谱,进一步促进中医药古籍的利用,开拓医生临床诊疗思路,提高中医临床疗效。The book Zhengzhi Huibu was written by LI Yongcui of the Qing Dynasty in the 26th year of Kangxi's reign.Its understanding of edema disease is very rich and has high clinical value.This article systematically analyzes the theory of etiology,mechanism,and treatment of edema disease,and constructs the theoretical framework of edema diagnosis and treatment in the book Zhengzhi Huibu.It is stated that edema disease is caused by various dampness and swelling,all of which belong to the spleen and kidney deficiency.Water seeps into the skin and the lungs lose circulation,leading to the stagnation of water regulating fluids.At the same time,it is transmitted through the lungs and kidneys.The diagnosis and treatment should distinguish between types such as Yang water and Yin water,emphysema and edema,wind swelling and stasis,wind water and stone water,water content and blood content,and pay attention to the causes of wheezing and swelling,edema pulse method,and edema mortality.Taking“regulating the middle and strengthening the spleen”as the main treatment method,the treatment should be divided into Yin and Yang,sweating and exudation,dampness and heat should be cleared,cold and dampness should be warmed,Yin deficiency should be supplemented,and evil excess should be attacked.The main formula of Siling Powder(四苓散)is modified,and the medication is adjusted according to the condition.The formula also includes Jinkui Shenqi Pills(金匮肾气丸),Zhufu Decoction(术附汤),Modified Dihuang Decoction(地黄汤加味),Jiaoren Pills(椒仁丸),and Modified Qianniu Gansui(牵牛甘遂加味).The external treatment method involves adding Shexiang(Moschus),Lougu(Mole Cricket),Tianluo(River Snail),Dasuan(Allii Sativi Bulbus),Cheqiancao(Plantaginis Herba)and other herbs to Shanglu(Phytolaccae Radix).Preventive measures include avoiding sweet and warm medicines,avoiding acupuncture,avoiding alcohol and color,avoiding salt and sauce,and avoiding anger.And based on the above content,draw a theoretical framework diagram for the

关 键 词：证治汇补 水肿 诊疗框架 图谱 

分 类 号：R256.51[医药卫生—中医内科学]