张伯礼运用达原饮辨治湿浊类病思路探析  

Professor ZHANG Boli′s Differentiation and Treatment of Dampness-turbidity Diseases Based on Dayuan Decoction

作　　者：昝树杰 王凯[2] 秦广宁 高宁 刘耀远 苗婧超 田盈 ZAN Shujie;WANG Kai;QIN Guangning;GAO Ning;LIU Yaoyuan;MIAO Jingchao;TIAN Ying(Tianjiin University of Traditional Chinese Medicine,Tianjin 301617,China;Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学第二附属医院,天津300250

出　　处：《世界中医药》2024年第23期3660-3663,共4页World Chinese Medicine

基　　金：国家中医药管理局国医大师传承工作室建设项目;中国中医科学院科技创新工程学部委员学术传承与传播项目(CI2022E025XB);第七批全国老中医药专家学术经验继承工作项目。

摘　　要：达原饮是治疗瘟疫的经典名方。国医大师张伯礼教授创“湿浊痰饮类病”学说,临床治以开达膜原之法,运用达原饮治疗湿浊类病,临床疗效确切。本文先介绍案例,然后探析张伯礼运用达原饮辨治湿浊类病思路。湿浊痰饮类病的病机:湿浊内伏膜原是湿浊痰饮类病缠绵难治的关键病机;湿浊久羁酿毒是类病恶化的重要基础。膜原理论与达原饮方证要旨:膜原理论与达原饮方证要旨膜原证治重在“开达”;开达膜原治在“求变”。达原饮临证运用思路:古方今病,再识邪伏膜原之证,芳香疏利,解湿浊胶结之态,化浊解毒,治类病恶化之势。Dayuan Decoction is a classic prescription for treating epidemic diseases.Professor ZHANG Boli,a renowned traditional Chinese medicine(TCM)expert,established the theory of“dampness-turbidity and phlegm-fluid diseases”and clinically treated these conditions using the method of“opening onto pleurodiaphragmatic interspace”.The application of Dayuan Decoction to treat dampness-turbidity diseases has shown clear clinical efficacy.This article first introduces a case study and then explores Professor ZHANG Boli′s approach to differentiating and treating dampness-turbidity diseases using Dayuan Decoction.The pathogenesis of dampness-turbidity and phlegm-fluid diseases is primarily due to the internal accumulation of dampness and turbidity in pleurodiaphragmatic interspace,which become difficult to treat and cause prolonged illness.The long-term retention of dampness-turbidity substances leads to toxin formation,which serves as an important foundation for the disease′s deterioration.The theory of pleurodiaphragmatic interspace and the essential principles of Dayuan Decoction are outlined as follows:pleurodiaphragmatic interspace treatment emphasizes“opening and expelling”the accumulation,while the approach of“seeking transformation”is key to treatment.The clinical application of Dayuan Decoction follows these principles:the ancient prescription is applied to modern diseases,recognizing the presence of hidden pathogens in the pleurodiaphragmatic interspace.Aromatic drugs are used to expel and resolve the dampness-turbidity accumulation,remove toxins,and treat the disease′s deterioration.

关 键 词：达原饮 开达膜原 湿浊类病 “湿浊痰饮类病”学说 张伯礼 辨证治疗 中医药 名医经验 

分 类 号：R242[医药卫生—中医临床基础]