徐灵胎寒嗽辨治思路探析  

Trial Analysis of XU Lingtai Cold Cough Treatment Thinking

作　　者：杨智鑫 汪天青 马剑明 刘锦河 尹小倩 YANG Zhixin;WANG Tianqing;MA Jianming;LIU Jinhe;YIN Xiaoqian(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁沈阳110034

出　　处：《中西医结合慢性病杂志》2025年第1期69-73,共5页JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE ON CHRONIC DISEASES

基　　金：中国中医药科技发展中心项目(CXZH04);辽宁省自然科学基金计划项目(2024-MS-261);沈阳市科学技术计划项目(21-173-9-57)。

摘　　要：通过对徐灵胎的部分著作整理归纳、研究分析,综合相关医家的观点,梳理徐灵胎辨治寒嗽相关理法方药,探究发现寒嗽多因外之水湿阴邪侵袭,内之脾肾阳气不足,阴邪积聚,而致宗气之输布异常,肺胃水失布散,气机升降不利,浮阳携水而上,气逆发为咳嗽。从而形成了以温药和之为原则,水在中则利小便,水在四肢则发汗的辨治思路,体现出利小便以苓桂类方为主,发汗以麻黄类方为要,急性期以小青龙汤类方加减,缓解期以苓甘五味姜辛汤类方变化的选方特色,而其用药则以症选药,有是症则用是药,尊古而不拘泥于古,灵活而又不失严肃。治疗寒嗽以调节水气平衡为标,以理脏腑虚实为本,标本兼顾,表里同治,通过调整津液输布与气机升降的手段,使脏腑荣于所养,各顺其性,进而使清浊相别,阴阳平衡,从根本上防治寒嗽,避免疾病的反复迁延,减轻患者负担,同时为临床辨治寒嗽提供理论借鉴,丰富治疗思路。By summarizing,,researching,and analyzing some of XU Lingtai's works,and integrating the views of relevant medical experts,this study sorted out the relevant principles,methods,and medicines for treating cold cough in XU Lingtai.It was found that cold cough is often caused by the invasion of external water dampness and Yin evil,insufficient spleen and kidney Yangqi,and accumulation of Yin evil,resulting in abnormal distribution of clan Qi,loss of lung and stomach water dispersion,unfavorable rise and fall of Qi,floating Yang carrying water,and Qi reversal leading to cough.Thus,a diagnostic and therapeutic approach was formed based on the principle of harmonizing warm herbs,with water in the middle promoting urination,and water in the limbs promoting sweating.This approach reflects the selection of formulas mainly based on the Linggui formula for promoting urination,the Mahuang formula for promoting sweating,the modified Xiaoqinglong Decoction(小青龙汤)formula for the acute phase,and the modified Linggan Wuwei Jiangxin Decoction(小青龙汤)formula for the relief phase.The medication is selected based on the symptoms,and the specific medication is used for the specific condition.It respects the past without being confined to it,and is flexible yet serious.The treatment of cold cough is based on regulating the balance of water and air,treating the deficiency and excess of organs,balancing the symptoms,and treating both the surface and the interior.By adjusting the distribution of body fluids and the rise and fall of Qi,the organs are nourished and regulated according to their nature,thereby distinguishing between clear and turbid,balancing Yin and Yang,fundamentally preventing and treating cold cough,avoiding the recurrence and delay of the disease,reducing the burden on patients,and providing theoretical reference for clinical diagnosis and treatment of cold cough,enriching treatment ideas.

关 键 词：徐灵胎 寒嗽 脾肾 水饮 肺胃 温药和之 

分 类 号：R256.11[医药卫生—中医内科学] R441.5[医药卫生—中医学]