张喜奎教授经方辨治泄泻经验  

Professor Zhang Xikui′s experence on diarrhea treatment by classical prescription

作　　者：肖中付 朱为坤[1] 黄国芳 张思腾 黄孟珂 阮叶永盛 叶宝叶[3] 张喜奎[3] XIAO Zhongfu;ZHU Weikun;HUANG Guofang;ZHANG Siteng;HUANG Mengke;RUAN-YE Yongsheng;YE Baoye;ZHANG Xikui(College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou350122,China;Department of Massage,Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou350003,China;Department of Rehabilitation,the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou350003,China)

机构地区：[1]福建中医药大学中医学院,福建福州350122 [2]福建中医药大学附属康复医院推拿科,福建福州350003 [3]福建中医药大学附属第二人民医院康复科,福建福州350003

出　　处：《中国当代医药》2024年第33期104-107,共4页China Modern Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);福建省名老中医药专家传承工作室建设项目(闽卫中医函〔2023〕697号)。

摘　　要：张喜奎教授长期从事《伤寒论》的教学、科研以及临床工作,熟练并灵活运用《伤寒论》六经辨证治疗临床各种疑难杂症。在泄泻的临床治疗方面,其认为《伤寒论》六经皆见有泄泻,然其病位始终与脾胃相关。太阳病泄泻主要病机有:太阳邪热入里,下迫大肠、太阳病误治损伤脾胃。阳明病泄泻主要病机有:热结旁流、脾胃功能紊乱、大肠传导及主津功能失调。少阳病泄泻主要病机为少阳病胆热犯胃。太阴病泄泻主要病机有:水湿运化失司,下注大肠、太阴脾虚不升。少阴病泄泻主要病机有:因少阴阳虚,火不暖土,以致脾胃虚寒;少阴阳虚不能化水,水饮内停,下注大肠;少阴阴虚,水热互结;少阴阴虚,燥屎内结。厥阴病泄泻病机多为寒热错杂,多与脾肾阳虚相关。在治法上,张喜奎教授常用经方联合祛湿法进行治疗,并擅长运用固涩止泻法。Professor Zhang Xikui has been engaged in the teaching,scientific research and clinical work of Treatises on Febrile Diseases for a long time,skillfully and flexibly applying the six channels of Treatises on Febrile Diseases to treat various complicated clinical syndromes.In the clinical treatment of diarrhea,he thinks that diarrhea can be found in all six channels of Treatise on Febrile Diseases,but its location is always related to the spleen and stomach.The main pathogenesis of Taiyang disease diarrhea are:the Taiyang evil heat enters the inside,forces the large intestine,and therapeutic error of the sun disease hurts the spleen and stomach.The main pathogenesis of diarrhea in Yangming disease are:heat fecaloma with watery discharge,spleen and stomach dysfunction,large intestine conduction and main body dysfunction.The main pathogenesis of diarrhea in Shaoyang disease is gallbladder heat invading stomach.The main pathogenesis of diarrhea in Taiyin disease are:dysfunction of transmitting and distributing the fluids,dampness injects into the large intestine,Taiyin spleen deficiency.The main pathogenesis of diarrhea of Shaoyin disease are:deficiency of yin and yang,fire does not warm the earth,resulting in deficiency of the spleen and stomach.Shaoyin has yang deficiency,can not transform dampness,dampness injects into the large intestine.Shaoyin has yin deficiency,water and heat interjunction.Shaoyin has yin deficiency,dry stool accumulating in the intestine.The pathogenesis of diarrhea in Jueyin disease is mostly mixed cold and heat,which is mostly related to the deficiency of spleen and kidney yang.In terms of treatment,Professor Zhang Xikui commonly uses the combination of prescription and dampness dispelling method for treatment,and is good at the use of stopping diarrhea with astringents method.

关 键 词：《伤寒论》 经方 泄泻 祛湿法 固涩止泻法 

分 类 号：R249[医药卫生—中医临床基础]