严季澜从肝论治百合病经验  

Yan Jilan′s Experience of Treating Lily Disease from a Liver-Centered Perspective

作　　者：于东平 温佳雨 YU Dongping;WEN Jiayu(Qi Huang Chinese Medicine School,Beijing University of Chinese Medicine,Beijing,China,100029;College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing,China,100029)

机构地区：[1]北京中医药大学岐黄学院,北京100029 [2]北京中医药大学中医学院,北京100029

出　　处：《河南中医》2025年第2期234-238,共5页Henan Traditional Chinese Medicine

基　　金：2022教育部人文社会科学研究青年项目(2022-JYB-2357)。

摘　　要：严季澜教授认为,百合病多因平素情志不舒,或偶遇外界情志刺激而引发,内因是情志失调、气机不畅,伤及心、肝、肺三脏,脏腑功能受损,心不藏神,肝气郁结,肺失宣肃,故而为病。严教授认为,百合病的核心病机是气机不畅,郁久化热,热伤阴津,终致气阴两虚,治疗上重视疏通气机,而后益气养阴,宁心清热,故从肝论治,调节气机升降,合清凉生津之品,达到气血流畅、阴阳调和的目的。阴虚内热证,治法为清热润肺,方选百合地黄汤加减;痰热内扰证,不能过分应用凉药,而是清化痰热,方选黄连温胆汤加减;心肺气虚证,治法为益气安神,方选甘麦大枣汤合生脉散;肝郁气滞证,治法为疏肝理气,方选小柴胡汤加减。Professor Yan Jilan believes that modern lily disease often arises from emotional imbalance due to long-term mental discomfort or sudden emotional stimuli.The root cause is internal,stemming from emotional dysregulation and disrupted qi flow,which impair the functions of the heart,liver,and lung.The resulting dysfunction leads to the heart failing to store the spirit,liver qi stagnation,and the lung losing its descending and dispersing function,resulting in lily disease.Professor Yan identifies the core pathogenesis of lily disease as stagnated qi that transforms into heat,damaging yin fluids and ultimately resulting in qi and yin deficiency.Treatment emphasizes smoothing the qi flow,followed by nourishing qi and yin,calming the mind,and clearing heat.Thus,the therapeutic approach focuses on the liver,regulating the ascending and descending of qi and combining cooling and fluid-generating drugs to achieve a smooth qi and blood flow and balance yin and yang.For syndrome of yin deficiency and internal heat,the treatment method involves clearing heat and moistening the lung,using Modified Lily Bulb and Rehmannia Decoction.For syndrome of internal phlegm-heat disturbance,excessive cooling drugs should be avoided,and the focus is on clearing and transforming phlegm-heat,using Modified Coptis Gallbladder-Warming Decoction.For syndrome of heart and lung qi deficiency,the approach involves replenishing qi and calming the mind,using a combination of Licorice and Wheat and Jujube Decoction and Pulse-Engendering Powder.For syndrome of liver depression and qi stagnation,the treatment emphasizes soothing the liver and regulating qi,using Modified Minor Bupleurum Decoction.

关 键 词：百合病 从肝论治 阴虚内热证 痰热内扰证 心肺气虚证 肝郁气滞证 百合地黄汤 黄连温胆汤 甘麦大枣汤 生脉散 小柴胡汤 严季澜 

分 类 号：R256.28[医药卫生—中医内科学]