吴鞠通“诸痹独取太阴”之内涵与应用  

Connotation and Application of WU Jutong′s Theory of"Treating All Bi(痹)Diseases through Taiyin"

作　　者：孟亮 康帅 金泉 魏千程 MENG Liang;KANG Shuai;JIN Quan;WEI Qiancheng(Lintao Shujitang Rheumatism and Osteopathy Traditional Chinese Medicine Hospital,Dingxi,Gansu Province,Dingxi,Gansu Province,730500;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine;The Third People′s Hospital of Gansu Province)

机构地区：[1]甘肃省定西市临洮蜀佶堂风湿骨病中医院,甘肃定西730500 [2]北京中医药大学中医学院 [3]甘肃省第三人民医院

出　　处：《中医杂志》2025年第1期102-106,共5页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局第六批全国老中医药专家学术经验传承项目;甘肃省卫生健康行业科研计划项目(GSWSKY2020-43)。

摘　　要：《吴鞠通医案》提出“诸痹独取太阴”,基于此分析吴鞠通对痹证病因病机、辨证治法的认识,为痹证的临证诊治提供参考。通过对“诸痹独取太阴”训词释句,认为痹证成因多源自湿气,治疗时须着眼肺脾二脏。强调痹证成因有四(风、寒、湿、热),湿居其要,其病位首先在肺,外湿侵袭首先犯肺,内湿湮郁水之上源,均可壅遏肺气而使气不外宣,湿邪流注关节而成痹证。吴鞠通提出治痹之祖方为加减木防己汤,通过分析加减木防己汤与木防己汤的异同,从方药加减变换角度,以方药测证进一步佐证“诸痹独取太阴”的临证特色。The Medical Cases of WU Jutong(《吴鞠通医案》)proposes the principle of"treating all Bi(痹)diseases through taiyin",which forms the basis for analyzing WU Jutong′s understanding of the causes,mechanisms,and treatments of Bi(痹)diseases,providing a reference for clinical diagnosis and treatment.Through an interpretation of the phrase"treating all Bi(痹)diseases through taiyin",it is suggested that Bi(痹)diseases is primarily caused by dampness,necessitating a focus on spleen and lung in treatment.WU emphasized four main causes of Bi(痹)diseases(wind,cold,dampness,and heat),with dampness being the predominant factor.The disease location is initially in lung,for which external dampness invades lung first,and internal dampness obstructs the source of water metabolism,impeding lung qi and qi failing to disperse,then dampness further accumulates in the joints,leading to Bi(痹)diseases.WU Jutong proposed the modified Mufangji Decoction(木防己汤)as the foundational prescription for treating Bi(痹)diseases.By comparing the similarities and differences between the modified and original Mufangji Decoction,and analyzing the adjustments in herbal prescriptions,the clinical characteristic of"treating all Bi(痹)diseases through taiyin"is further substantiated.

关 键 词：痹证 太阴 吴鞠通 加减木防己汤 

分 类 号：R255.6[医药卫生—中医内科学]