叶天士“二虚一实,偏治其实”治疗思想探析  

Ananalysis of Ye Tianshi's therapeutic thoughts of“Two Deficiency and One Reality,Partial Treatment of Actuali-ty”

作　　者：马松 郑旭锐[1] 蒋啸 刘东昊 MA Song;ZHENG Xurui;JIANG Xiao(Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《四川中医》2025年第4期38-40,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家中医药管理局第四批中医基础优秀人才资助项目(编号:J20184832009)。

摘　　要：叶氏医案中“二虚一实,偏治其实,开其一面”之说有着深刻的理法内涵,叶天士在治疗年老体衰、久病失治等各种因素导致患者病体虚弱并兼有实邪,虽患者以虚证为主,但正气尚可耐受的情况下,医家亦可以先祛除“一实”,再补其“二虚”。“二虚”代表患者病体虚弱程度较重的一种情况,此种情况相对来说较易被医者所察觉;“一实”指病者病体气机胶塞不畅的一种情况,这种情况往往隐藏在“二虚”的表象之下,易被医者所忽视。但“一实”却常是疾病治疗的关键所在,“一实”不开,则“二虚”难补。此治法的提出,给后世医家在治疗虚中夹实病证中,提供一种新的治疗思路。In Ye's medical case,the theory of“two deficiency and one real,partial treatment is in fact open to one side”has profound theoretical and legal connotations.A condition in which the patient's physical weakness is severe,such as deficiency of both qi and blood,deficiency of both yin and yang,and deficiency of both internal organs,etc.This situation is relatively easy to be detected by doctors;“one real”means internal turbidity due to heat and dampness Obstruction of gas in the stomach,damp heat,blood stasis,and other tangible or intangible evils.A condition in which the patient's body qi is not smooth.This condition is often hidden under the appearance of“two deficiency”.Easy to be ignored by doctors.However,“one reality”is often the key to disease treatment.If the“one reality”is not opened,the"two deficiency"cannot be made up.

关 键 词：叶天士 二虚 一实 偏治其实 

分 类 号：R229[医药卫生—中医基础理论]