基于《王仲奇医案》探讨咳嗽辨治特色  

Discussion on the characteristics of cough diagnosis and treatment based on Wang Zhongqi′s Case Records

作　　者：高志 孙培养[2] Gao Zhi;Sun Peiyang(Anhui University of Chinese Medicine,Hefei Anhui 230038;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230061)

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《山西中医药大学学报》2024年第11期1289-1293,共5页Journal of Shanxi University of Chinese Medicine

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕1号);第七批全国名老中医药专家学术经验继承工作项目(国中医药人教函〔2022〕76号);储浩然全国名老中医药专家传承工作室(国中医药人教函〔2022〕75号);安徽省第一届卫生健康杰出人才项目(皖卫函〔2022〕392号);安徽省重大疑难疾病中西医协同攻关项目(皖中医药发展秘〔2021〕70号);黄学勇安徽省名中医工作室建设项目(中发展〔2022〕5号)。

摘　　要：咳嗽是临床常见的病症,病机繁多,病情复杂,历代医家治疗咳嗽的方法层出不穷,然临床中常虚实夹杂,阴阳难分。新安医家王仲奇先生对前人治疗咳嗽的思路博采众长,以其师古不泥的学术风格及其独特的辨证及用药思路为临床上治疗咳嗽提供了更多方法。王仲奇在临证中从脏腑辨证理论入手,善以脾胃为中心切入辨证。从恢复脾胃升降之功治气,从补益肾阳温煦之用治痰;重视标本轻重,急则治标,缓则治本;重视病位、病机所在,热者寒之,寒者热之。基于《王仲奇医案》中记载的病案探讨其治疗咳嗽的学术思想包括:咳嗽气逆者,当脾胃治之;咳嗽肺寒者,当温肾论之;咳嗽痰饮者,当温药和之;咳嗽痰热者,当补泻兼之。Cough is a common clinical symptom with numerous pathogenic mechanisms and complex conditions.Throughout history,there have been countless methods for treating cough,yet in practice,it often presents with mixed deficiency and excess symptoms,making it difficult to differentiate between Yin and Yang.Wang Zhongqi,a renowned physician from the Xin′an School of TCM,draws on the wisdom of his predecessors and develops a unique approach to diagnosis and treatment based on his scholarly style of learning from tradition without being bound by it.In clinical practice,Wang Zhongqi focuses on the theory of zang-fu differentiation,emphasizing the role of the spleen and stomach in differential diagnosis.He treats Qi disorders by restoring the ascending and descending functions of the spleen and stomach,treats phlegm by tonifying kidney-Yang,prioritizes treating the symptoms in acute cases and the root cause in chronic cases,and addresses the location and mechanism of the disease by applying cooling treatments for heat and warming treatments for cold.Based on the cases recorded in Wang Zhongqi′s Case Records,this paper discusses his academic ideas on cough treatment,which include treating cough with Qi reversal by focusing on the spleen and stomach;treating cold lung cough by warming the kidney;treating cough with phlegm and fluid retention by using warming and harmonizing drugs;and treating cough with phlegm and heat by combining tonifying and draining approaches.

关 键 词：咳嗽 王仲奇 新安王氏 医案 

分 类 号：R256.11[医药卫生—中医内科学]