北京名医施今墨先生辨治痹证思想及经验  

SHI Jinmo,a Famous Doctor in Beijing,Distinguished His Thoughts and Experience in Treating Paralysis

作　　者：黄子琴 程方俊 董宇昂 王彤彤 卞志庆 张珺[3] HUANG Ziqin;CHENG Fangjun;DONG Yuang;WANG Tongtong;BIAN Zhiqing;ZHANG Jun(Anhui University of Chinese Medicine Anhui Hefei 230012,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230012 [2]安徽中医药大学医药信息工程学院,安徽合肥230012 [3]安徽中医药大学中医学院,安徽合肥230012

出　　处：《中医药临床杂志》2024年第10期1883-1887,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金委员会,面上项目(编号:82174160);省级大学生创新创业训练项目(编号:S202310369162);中医学院重点学科(校级)DC18100035。

摘　　要：痹证是现代内科临床常见和多发疾病之一,具有反复发作、病程长、缠绵难愈等特点,发病率逐年上升。现代医学认为其与遗传、环境多种因素有关,目前对于其发病机制的研究尚不明确,治疗手段不全面且预后欠佳。施今墨先生是中国近代临床医学家、教育家、改革家,京城四大名医之一,创立施氏学派。潜心耕耘中医事业六十余年,对消渴、传染病、痹证等疾病研究颇深,临证善用对药。通过研读《施今墨临床经验集》《祝选施今墨医案》中辨治痹证的思想内容和医案,整理其所载方剂及药物。分别从辨证思想、用药特色、学术特色三个方面分析施今墨先生的痹证思想,总结归纳临证用药的特点,并结合相关典型案例进一步阐述其遣方用药的思路。施今墨先生认为气血是人体物质的基础,在辨证痹证时以八纲为要,并重视气血,以辨风湿热证候、风寒湿证候、气血实证候、气血虚证候四型为则;并自立散风、逐寒、祛湿、清热、补虚、行气、活血、通络八法逐个攻破,疗效确切;同时该文挖掘到施氏学派“西医辨病、中医辨证”的学术特色,将西医的诊断、病理分析等与中医辨证论治的思维相融合。该研究以期为继承、应用、发扬名老中医的临证经验和现代临床提供新的思路。Bi syndrome is one of the common and frequent diseases in modern internal medicine.It has the characteristics of repeated attacks,long course of disease,lingering and difficult to cure,and the incidence rate is increasing year by year.Modern medicine believes that it is related to genetic and environmental factors.At present,the research on its pathogenesis is still unclear,the treatment methods are not comprehensive and the prognosis is poor.Mr.SHI Jinmo is a modern Chinese clinical physician,educator,reformer,one of the four famous doctors in Beijing,and the founder of the SHI School.He has devoted himself to the cause of traditional Chinese medicine for more than 60 years,and has made in-depth research on diseases such as thirst,infectious diseases,and Bi syndrome.He is good at using the right medicine in clinical practice.By studying the ideological content and medical records of Bi syndrome in“SHI Jinmo’s Clinical Experience Collection”and“Zhu Xuan SHI Jinmo’s Medical Cases”,the prescriptions and drugs contained in them are sorted out.Mr.SHI Jinmo’s Bi syndrome thinking is analyzed from three aspects:syndrome differentiation thinking,drug use characteristics,and academic characteristics.The characteristics of clinical drug use are summarized,and his ideas on prescription and drug use are further explained in combination with relevant typical cases.Mr.SHI Jinmo believed that Qi and blood are the material basis of the human body.When distinguishing Bi syndrome,the eight principles are the key,and Qi and blood are emphasized.The four types of syndromes are distinguished:wind-rheumatic heat syndrome,wind-cold-damp syndrome,Qi and blood excess syndrome,and Qi and blood deficiency syndrome.He independently established eight methods of dispersing wind,expelling cold,removing dampness,clearing heat,replenishing deficiency,promoting Qi,activating blood circulation,and unblocking meridians to break through them one by one,with definite curative effect.At the same time,this article excavates the academic

关 键 词：施今墨 风湿病 痹证 类风湿性关节炎 名医经验 

分 类 号：R255.6[医药卫生—中医内科学]