摘要
痼疾观贯穿张仲景辨治伤寒与杂病的始终。如今医学日益昌明,但是对以慢性复杂性疾病为主的痼疾辨治依然存在困难。通过对张仲景痼疾观的深入探讨,可见张仲景以诸"家"如饮家、喘家、淋家等建立起了涉及多脏腑的痼疾模型。痼疾的类型也以发病特点分为伏藏体内反复发作型;迁延岁月难以卒愈型;发展传变逐渐恶化型。分析痼疾的病机多寒热并见;虚实互呈;多脏腑同病;甚至入络成癥。故此,在慢性复杂性疾病的治疗中首当把握传变规律,精准辨证,也可独辟蹊径,从体质论治。治疗慢性复杂性疾病提倡初病时早期治疗、已病者须长期治疗的原则。卒病会诱发痼疾的反复发作,并与痼疾胶结,导致疾病发展难以预测,故而调治痼疾的同时也要时时预防卒病。
‘Gu Ji’ was reflected in ZHANG Zhong-jing’s treatment of typhoid fever and miscellaneous diseases. Nowadays, medicine is becoming more and more prosperous. However, there were still difficulties in the treatment of ‘Gu Ji’ dominated by chronic complex diseases. Through in-depth discussion of ZHANG Zhong-jing’s concept of ‘Gu Ji’, it can be seen that ZHANG Zhong-jing has established many models of ‘Gu Ji’ involving multiple organs with various ‘Jia’ such as ‘Yin Jia’, ‘Chuan Jia’, and ‘Lin Jia’. The types of ‘Gu Ji’ were also divided into latent disease, persistent disease and worsening disease. The pathogenesis of ‘Gu Ji’ was as follows: heat and cold, deficiency and excess exist together;more visceral disease;even becoming lump in the main and collateral channels. Therefore, in the treatment of chronic complex diseases, we should first grasp the law of transformation, and accurately distinguish syndromes. Besides, we can also take a different approach and treat it from physical constitution. In the treatment of chronic complex diseases, it was wise to promote treatment in early stages of disease, and the principle of long-term treatment of patients already suffering from chronic complex disease. Sudden illness can induce recurrent episodes of ‘Gu Ji’, and cemented with ‘Gu Ji’, which leading to unpredictable disease. Therefore, it is necessary to prevent sudden illness from time to time.
作者
肖啸
张琦
XIAO Xiao;ZHANG Qi(Chengdu University of TCM,Chengdu 610072,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2020年第5期2248-2253,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
关键词
张仲景
伤寒论
金匮要略
家
痼疾
慢性复杂性疾病
中医辨治
ZHANG Zhong-jing
Shanghan Lun
Jingui Yaolue
Jia
Gu Ji
Chronic complex diseases
Syndrome differentiation and treatment of TCM
