摘要
贾跃进继承朱震亨的六郁思想,强调百病生于气,并加以发挥,提出气郁、食郁可致湿郁,湿郁可致血郁、痰郁、气郁、火郁、血郁、寒郁、水郁,导致多郁兼夹。湿郁并非均为实证,久病多为虚郁之证,气虚、阳虚亦可导致湿郁。并论述湿郁所形成的原因,以及湿郁的表现。治疗关键在于审证求因。若为虚郁夹杂,当补中兼疏;若为气虚所致湿郁,当健脾益气,化湿解郁,方以三仁汤合香砂六君子汤加减;若为阳虚所致湿郁,当补脾肾之阳,化湿解郁,方以附子理中汤合三仁汤加减;若为湿郁兼有气郁,当行气化湿解郁,方以四逆散合藿朴夏苓汤加减;若为湿郁兼有血郁,当行气活血,化湿解郁,方以三仁汤合四物汤加减;若为湿郁兼有痰郁,当行气燥湿化痰,方以二陈丸合平胃散加减;若为湿郁兼有火郁,当行气化湿,分消郁热,方以四妙散合泻黄散加减;若为湿郁兼有寒郁,当行气化湿,温散寒邪,方以羌活胜湿汤加减;若为湿郁兼有水郁,当行气化湿,温化水饮,方以三仁汤合苓桂术甘汤加减。并强调苍术为治疗湿郁要药,三仁汤为治疗湿郁之证的要方,善用三仁汤、四妙散、藿朴夏苓汤治疗各种类型的湿郁之证。
JIA Yuejin inherited ZHU Zhenheng’s theory of six depressions,emphasizing that all diseases arise from Qi(气).He Jproposed that Qi depression and food depression can lead to dampness depression,while dampness depression can lead to blood depression,phlegm depression,Qi depression,fire depression,blood depression,cold depression,and water depression,resulting in a combination of multiple depression.Dampness depressions are not all excess symptoms.Prolonged illness is often characterized by deficiency and depression,and Qi deficiency and Yang(阳)deficiency can also lead to dampness depression.And the reasons for the formation of dampness depression were discussed,as well as the manifestations of dampness depression.The key to treatment lies in examining the syndrome and finding the cause.If it is a mixture of deficiency and depression,it should be supplemented and catharsis.If it is dampness depression caused by deficiency of Qi,the methods of invigorating the spleen and tonifying Qi,and resolving dampness and depression should be used,the formula is modified with the Sanren decoction(三仁汤)plus the Xiangsha Liujunzi decoction(香砂六君子汤).If it is caused by deficiency of Yang,it is necessary to supplement the Yang of the spleen-kidney,transform dampness and relieve depression,and then use the Fuzi Lizhong decoction(附子理中汤)and the Sanren decoction.If there is both dampness depression and Qi depression,it is necessary to transform dampness into Qi and relieve depression.The formula is Sini San(四逆散)with the Huopo Xialing decoction(藿朴夏苓汤).If there is both dampness depression and blood depression,it is necessary to promote Qi and blood circulation,transform dampness and relieve depression,and then use the Sanren decoction plus the Siwu decoction(四物汤)with modifications.If there is both dampness depression and phlegm depression,it is necessary to promote Qi,vaporize dampness and transform phlegm,and then use Erchen Wan(二陈丸)and Pingwei San(平胃散).If there is both dam
出处
《中医临床研究》
2024年第19期74-77,共4页
Clinical Journal Of Chinese Medicine
基金
山西省中医药管理局科研课题(2024ZYYC061)
山西省哲学社会科学规划课题(2022YJ092):山西省道地中药药象学文献研究
山西中医药大学博士科研启动基金项目(2022BK12,2022BKS03)
山西省高等学校教学改革创新项目(J20230991)
国家中医药管理局全国名老中医药专家传承工作室建设项目——贾跃进名老中医药专家传承工作室(M020011190M)。
关键词
六郁
湿郁
因虚致郁
三仁汤
四妙散
Six depressions
Damp depression
Depression due to deficiency
The Sanren decoction
Simiao San
