摘要
痰浊中阻脾胃是中医临床常见、多发证型,临床表现多样,历代医家多有论述对其的治疗,也创立了诸如平胃散、二陈汤等一系列名方来治疗痰浊中阻证。但因痰浊中阻证临床表现多样,辨治较为复杂,临床难治病例较多。笔者于临证中积累治疗痰浊中阻证的丰富经验,主要如下:一是通因通用,给邪气以出路。给予通大便、利小便之法,双管齐下,前后二阴并重,必定事半功倍,痰浊速去。临证中常用大黄通肠府,用竹叶利小便。二是升降相因,复脾胃升降之职。待中焦脾胃升降有序,则痰浊邪气自然易祛。临证中常以枳壳配荷叶,升降相因,以复脾胃升降之职,待中焦脾胃升降有序,则痰浊邪气自然易祛。三是风药胜湿,祛肌肤腠理之痰。风药辛行温散之力甚著,故能挟诸药直达肌腠,祛除肌腠痰浊邪气。肌腠之痰既去,则中焦之痰易已。笔者在临证中常配伍防风、羌活、秦艽等祛风胜湿之品,疗效确切。四是加减化裁,守基本而顾他脏。五脏六腑之痰得祛,则中焦脾胃之痰浊易已。笔者临证治疗痰浊中阻证时,需注意守祛湿和中汤以祛中焦痰浊之根本,而兼顾他脏。五是三焦通调,通水道以祛邪。笔者在临证中,常借用三仁汤之蔻仁、苦杏仁、薏苡仁,临床疗效确切。客观来说,凡是祛邪,无论外感、内伤之不同,无论水、气、血之不同,皆可通调三焦,如此定能事半功倍,药到病除。
The obstruction in the spleen and stomach with phlegm and turbidities is a common type of TCM syndrome in clinical practice,which is with multiple clinical manifestations.Doctors of all dynasties have discussed its treatment,and also created a series of famous prescriptions such as Pingwei San(平胃散)and the Erchen decoction(二陈汤)to treat the obstruction in spleen and stomach with phlegm and turbidities.However,due to the various clinical manifestations of the syndrome of obstructing phlegm and turbidity,the differentiation and treatment is more complicated,and there are many refractory cases in clinical treatment.The author has accumulated rich experience in the clinical treatment of phlegm and turbidities obstruction,which is mainly summarized as follows.Firstly,the common cause is universal,and it needs to give evil Qi(气)a way out by promoting defecation and benefitting urine to relieve phlegm turbidity.Clinically,rhubarb is commonly used for relaxing bowels and bamboo leaves are used for promoting urine.Secondly,combining ascending with descending to harmonize the spleen and stomach and remove the phlegm and turbid evil.Clinically,fructus aurantii and lotus leaves are often used.Thirdly,wind medicinal cures dampness,which removes phlegm in striae of the skin,muscle and viscus.Clinically,paraffin,gentiana,gentiana,etc.are often applied to dispel wind and dampness.Fourthly,modification is made based on the situation of viscera and other organs,Chinese decoction is used to remove phlegm turbidity.Fifthly,triple-energizer is regulated thoroughly to remove evil.Clinically,the kernels,almonds and coix seeds in the Sanren decoction(三仁汤)are applied,and the clinical effect is definite.Objectively speaking,all the removal of evil,regardless of the difference between external sensation and internal injury,regardless of the difference between water,Qi and blood,can be adjusted through triple-energizer,so it will surely gain double the effect with half the effort and cure the disease.
作者
朱伟宁
王丽媛
孙建新
ZHU Weining;WANG Liyuan;SUN Jianxin
出处
《中医临床研究》
2021年第30期66-68,共3页
Clinical Journal Of Chinese Medicine
基金
山东省中医药科技发展计划项目(2019-0783)。
关键词
痰浊
脾胃中阻
辨治复杂
治疗思路
Phlegm turbidity
Obstruction in spleen and stomach
Complicated differentiation and treatment
Treatment thinking
