基于“通调五脏安脾胃”论治梅核气  

Treatment of Globus Hystericus Based on the Theory of"Regulating the Five Zang Organs and Harmonizing the Spleen and Stomach"

作　　者：张乃霖 王静西 王鸿洋 石芳[1,2] 景璇 刘启泉[1,2] ZHANG Nailin;WANG Jingxi;WANG Hongyang;SHI Fang;JING Xuan;LIU Qiquan(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang,05001l;Hebei Provincial Centre for Technological Innovation of Traditional Chinese Medicine Treatment of Spleen and Kidney Diseases;Graduate School,Hebei University of Chinese Medicine)

机构地区：[1]河北省中医院,河北省石家庄市050011 [2]河北省脾肾病证中医治疗技术创新中心 [3]河北中医药大学研究生学院

出　　处：《中医杂志》2025年第5期541-544,共4页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名中医传承工作室建设项目(国中医药办人教函[2018]119号);国家中医药管理局全国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);国家中医临床研究基地建设项目(国中医药科技函[2018]131号);河北省自然科学基金(H2024423016)。

摘　　要：基于“通调五脏安脾胃”观点,认为梅核气核心病机在于五脏失调、脾胃不安,治疗主张以调治脾胃为要,并兼顾他脏,自拟安脾胃经验方作为治疗梅核气的基础方。同时针对心、肺、肾、肝四脏导致的梅核气进行随证加减,心阳不振者合用苓桂术甘汤加减,心阴亏虚者合用天王补心丹加减;肺失宣肃、水饮内停者合用三拗汤加减,肺胃阴虚者合用沙参麦冬汤加减;肾阳虚损、寒水上逆者合用金匮肾气丸加减,肾阴亏虚者合用六味地黄丸加减;肝郁脾虚者合用四逆散加减,肝阴不足、肝郁化火犯胃者合用一贯煎加减。Based on the concept of"regulating the five zang organs and harmonizing the spleen and stomach",globus hystericus is believed to originate from dysfunction of the five zang organs and disharmony of the spleen and stomach.Treatment primarily focuses on regulating the spleen and stomach while also considering other affected organs,with a self-prescribed Anpiwei Jingyan Formula(安脾胃经验方)for harmonizing the spleen and stomach as the foundational treatment.Additionally,syndrome-based modifications are applied according to imbalances in the heart,lung,kidney,or liver.For heart-yang deficiency,modified Linggui Zhugan Decoction(苓桂术甘汤)could be combined;for heart-yin deficiency,modified Tianwang Buxin Pill(天王补心丹)could be combined.For lung failing to disperse and descend and fluid retention,modified Sanao Decoction(三拗汤)could be combined;for lung and stomach yin deficiency,modified Shashen Maidong Decoction(沙参麦冬汤)could be combined.For kidney-yang deficiency with ascending counterflow of cold water,modified Jingui Shensi Pill(金匮肾气丸)could be combined;for kidney-yin deficiency,modified Liuwei Dihuang Pill(六味地黄丸)could be combined.For liver constraint and spleen deficiency,modified Sini Powder(四逆散)could be combined;for liver-yin deficiency or liver stagnation transforming into fire and attacking the stomach,modified Yiguan Decoction(一贯煎)could be combined.

关 键 词：梅核气 通调五脏安脾胃 五脏相通 

分 类 号：R25[医药卫生—中医内科学]