基于脏腑学说探讨张仲景辨治梅核气  

Discussion on Zhang Zhongjing in Treating Globus Hystericus Based on Zang-fu Theory

作　　者：王建康 陈璐佳 张婷素 孙常波 邓颖萍 冯慧 WANG Jiankang;CHEN Lujia;ZHANG Tingsu;SUN Changbo;DENG Yingping;FENG Hui(Traditional Chinese Medicine Hall,Ningbo Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Zhejiang Province,Ningbo 315010,China;Prevention and Treatment Center,Ningbo Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Zhejiang Province,Ningbo 315010,China;Department of Oncology,Ningbo Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Zhejiang Province,Ningbo 315010,China;Department of Spleen and Stomach Diseases,Ningbo Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Zhejiang Province,Ningbo 315010,China;Department of Nephrology,Ningbo Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Zhejiang Province,Ningbo 315010,China;Department of Traditional Chinese Medicine,The Sixth Hospital of Ningbo,Zhejiang Province,Ningbo 315040,China)

机构地区：[1]浙江中医药大学附属宁波中医院名中医馆,浙江宁波315010 [2]浙江中医药大学附属宁波中医院治未病中心,浙江宁波315010 [3]浙江中医药大学附属宁波中医院肿瘤科,浙江宁波315010 [4]浙江中医药大学附属宁波中医院脾胃病科,浙江宁波315010 [5]浙江中医药大学附属宁波中医院肾病科,浙江宁波315010 [6]宁波市第六医院中医科,浙江宁波315040

出　　处：《光明中医》2024年第20期4067-4070,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(No.国中医药办人教函[2021]270号)。

摘　　要：以脏腑学说为指导,整理探讨张仲景《伤寒论》《金匮要略》有关梅核气病因病机、症状表现、类证鉴别、治疗方法的有关论述。仲景辨治梅核气并非半夏厚朴汤一方一法,凡心、肝、脾(胃)、肺、肾功能失常与风寒痰郁病邪复合,均可引起梅核气,其辨治可分为肾虚阳浮、气逆挟痰型,脾虚失运、痰饮阻结型,肺脾阳虚、痰气上扰型,胃膈郁热、风邪上扰型,肝郁犯胃、痰气交阻型,痰饮阻胃、风痰交结型,风热伤津、肝脾失调型8种证型,相应有治疗八法。并附运用仲景方治验1则,以示对临床的治疗意义和实用价值。Guided by the zang-fu theory,this paper discussed the etiology and pathogenesis,symptom manifestations,classification of syndromes and treatment methods of globus hystericus in Zhang Zhongjing's Treatise on Febrile Diseases and Synopsis of the Golden Chamber.As a result,Zhongjing's differentiation and treatment of globus hysteriocus is not a one-party method of Banxia Houpo decoction,and the combination dysfunction of heart,liver,spleen(stomach),lung,renal and wind cold phlegm depression can all cause globus hystericus.The differentiation and treatment can be divided into eight types,such as kidney deficiency yang floating,qi adverse phlegm inhibiting,spleen deficiency and phlegm inhibiting,phlegm inhibiting,yang deficiency of lung and spleen,spittoon disturbing,stomach depression heat suppressing,wind evil disturbing,liver depression causing stomach and spittoon inhibiting,phlegm obstruction of stomach,wind phlegm junction type,wind heat injury of fluid,liver and spleen disorder type,and there are eight treatment methods correspondingly.At last,given an example of an effective case which using Zhongjing prescription,that to show the clinical therapeutic significance and practical value.

关 键 词：梅核气 张仲景 脏腑学说 八型八法 医案 

分 类 号：R276.1[医药卫生—中医五官科学] R249[医药卫生—中医学]