基于“经络皆统血”理论探讨络病辨治在急症中的应用  

Study on the Application of Collateral Disease Differentiation and Treatment in Acute Conditions Based on the Theory of"Both Meridians and Collaterals Governing Blood"

作　　者：刘向辉 王玲玲 LIU Xianghui;WANG Lingling(Qingyang Hospital of Traditional Chinese Medicine,Qingyang,Gansu,China,745000)

机构地区：[1]庆阳市中医医院,甘肃庆阳745000

出　　处：《河南中医》2024年第11期1674-1678,共5页Henan Traditional Chinese Medicine

摘　　要：络脉既是气血实施调节转化和散布营养的场所,也是感应传导信息和邪气出入的通道,病邪侵入人体后的传变大致顺序为皮毛→阳络→经脉→六腑→五脏→阴络。络病不只是久病可致,新病亦可致。急病入络的特点为病势急、病情重、表里皆可受邪,阳络受邪时以风邪为主,“治风先治血,血行风自灭”,治疗当祛邪通络为主,祛邪多用风药,通络当用叶天士辛润通络之法。邪入阴络时多损伤脏腑功能,形成瘀血、水饮、腐肉等,进一步阻遏脏腑气机,影响脏腑功能,治疗应以祛邪、解毒、通络为法则,多用咸寒入血络的药物,使血络通而气机畅,方能达到祛邪的目的。中风急性期瘀阻脑络者,治以平肝熄风、化瘀通络,方用天麻钩藤饮合桃红四物汤加减;胸痹心痛瘀阻心络者,治以益气养阴、活血通络,方用血府逐瘀汤合天王补心丹加减;疫病瘀阻肺络者,治以化湿解毒、祛邪通络,方用清肺排毒汤加减。Meridians and collaterals are not only the sites where qi and blood are regulated,transformed,and distributed for nourishment,but also the channels through which information is transmitted and pathogens enter or exit.The general sequence of pathogenic transmission after invasion into the human body is from the skin and hair to yang collaterals,meridians,six fu organs,five zang organs,until yin collaterals.Collateral diseases can be caused not only by chronic illnesses but also by acute conditions.Acute collateral diseases are characterized by a rapid onset,severe conditions,and both exterior and interior of the body being affected by pathogens.When yang collaterals are affected,wind pathogen predominates,leading to disharmony of qi and blood and collateral stasis.As stated,"To treat wind,first treat blood,for when blood flows,the wind dissipates,"the treatment should focus on expelling pathogens and unblocking the collaterals.Expelling pathogens often involves using wind-dispelling drugs,while unblocking collaterals follows Ye Tianshi′s method of pungent-moistening to smooth the collaterals.When pathogens enter yin collaterals,they often damage the zang organs,forming blood stasis,fluid retention,or necrotic tissue,which further obstructs the qi movement of the organs and affects their functions.In such cases,the primary treatment principles are to expel pathogens,detoxify,and unblock the collaterals,using salty and cold drugs that enter the blood collaterals to clear blockages and restore the flow of qi and blood,thereby achieving the goal of eliminating pathogens.For acute cerebral infarction with obstruction of the brain collaterals,treatment should focus on calming the liver,extinguish wind,dissolving stasis,and unblocking the collaterals,so Modified Gastrodia and Uncaria Decoction combined with Peach Kernel and Carthamus Four Substances Decoction can be used.For chest pain due to stasis in the heart collaterals,the treatment should focus on tonifying qi,nourishing yin,invigorating blood,and unblocking the

关 键 词：络病 “经络皆统血” 急症 天麻钩藤饮 桃红四物汤 血府逐瘀汤 天王补心丹 清肺排毒汤 

分 类 号：R278[医药卫生—中医学]