叶天士运用通法治疗肾系疾病经验撷英  

YE Tianshi's Experience in Using Unblocking Method to Treat Kidney Diseases

作　　者：刘政新 朱佩琦 何伟明 LIU Zhengxin;ZHU Peiqi;HE Weiming(The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing,210029,China;The Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Provincial Hospital of Traditional Chinese Medicine)

机构地区：[1]南京中医药大学第一临床医学院,南京210029 [2]南京中医药大学附属医院/江苏省中医院

出　　处：《浙江中医药大学学报》2024年第8期991-995,共5页Journal of Zhejiang Chinese Medical University

基　　金：国家重点研发计划资助项目(2023YFC3502900);国家自然科学基金项目(82174294);2021年江苏省中医院项目(y2021rc16、k2021yrc16);江苏省中医肾病医学创新中心项目(苏卫科教[2022]15号)。

摘　　要：[目的]总结叶天士运用通法治疗肾系疾病的经验,从而为临床辨治肾系疾病提供思路。[方法]以《临证指南医案》为研究对象,结合《黄帝内经》《伤寒杂病论》等古籍论述,对叶天士运用通法治疗肾系疾病的经验进行总结。[结果]通法具有丰富内涵,凡有助于气血运行、有利于恢复机体正常生理状态的方法,皆可视为通法范畴。叶天士提出“凡病宜通”的学术主张,临证确立通络、宣通、柔通、通利以及通阳等诸多方法,启发了通法的临床运用。在肾系疾病的辨治上,叶天士尤其重视其肾气不通的病机,认为肾气不通引发的阴阳失和、痰湿瘀邪蕴积、奇经八脉不通、虚实夹杂是引发肾系疾病的关键,治疗上当重视通达肾气,在水肿、淋浊、遗精等肾系疾病的治疗上形成了“燮理阴阳,以通为用”“化瘀通络,通窍固肾”“运通奇经,通补肝肾”的治疗原则,并以此遣方用药,效果显著。[结论]叶氏运用通法治疗肾系疾病颇具特色,其辨证准确,理法清晰,用药精简,为运用通法辨治肾系疾病提供了思路。[Objective]To summarize the experience of YE Tianshi in the treatment of kidney diseases by unblocking method,so as to provide ideas for clinical differentiation and treatment of kidney diseases.[Methods]Taking Clinical Practice with Medical Records as the research object,combining with the discussion of ancient books such as Inner Canon of Yellow Emperor and Treatise on Febrile and Miscellaneous Diseases,the experience of YE Tianshi's treatment of kidney diseases with unblocking method was summarized.[Results]Unblocking method has a rich connotation.All methods that help the flow of Qi and blood and restoring the normal physiological state of the organism can be considered as unblocking method.YE Tianshi put forward the academic proposition of“all diseases should be treated with unblocking method”,and established many methods such as dredging collaterals,promoting free flow of Qi,removing blood stasis and promoting diuresis,activating Yang,which inspired the clinical application of unblocking method.In the identification and treatment of kidney diseases,YE Tianshi attached great importance to the pathogenesis of obstruction of kidney Qi,and considered that the disharmony of Yin and Yang,the pathogen of phlegm,dampness and blood stasis were accumulated,eight extraordinary meridians were blocked,deficiency interweaved with excess was the key to cause kidney diseases,treatment should pay attention to moving kidney Qi.In the treatment of edema,stranguria with turbid discharge disease,spermatorrhea and other kidney diseases,formed the treatment principles of“regulating Yin and Yang,functioning normally when unobstructed”“removing blood stasis and dredging collaterals,opening the orifices and invigorating the kidney”“dredging the eight extra meridians,tonifying the liver and kidney”,selected prescription and dispatching drugs,and achieved remarkable effects.[Conclusion]YE Tianshi's application of unblocking method in the treatment of kidney diseases has its own characteristics,which is accurate in synd

关 键 词：叶天士 肾系疾病 通法 经验 治疗 奇经 

分 类 号：R692[医药卫生—泌尿科学]