从《金匮要略》虚实异治思想论治风湿病

发布时间：2018-07-17 05:45

【摘要】：从《金匮要略》虚实异治思想出发,结合临床实际,系统论述风湿病的病因病机、临床表现及治法方药等,总结风湿病发病的根本原因在于正气亏虚,主要有肝肾亏虚、阴血不足、阳气亏虚等,以实邪侵袭为标,病理因素如风湿、寒湿、湿热、瘀血、痰浊等。治疗前当别虚实,并将辨证论治思想贯穿始终,以虚为主,缓则治本,应先扶正,分别给予补益脏腑、益气、养血、滋阴、温阳等治法,适用于正气亏虚严重和疾病缓解期;以实为主,急当治标,应先祛邪,给予祛风除湿、清热燥湿、利小便、微发汗、活血通脉等治法,适用于邪实正未虚、疾病初期、慢性疾病加重期;虚实夹杂者应根据虚实轻重与多少,分别以扶正兼祛邪、祛邪兼扶正、同时扶正祛邪等治疗原则,此型在临床上最常见。最后,通过列举临床病案深化对虚实异治思想的理解与临床应用。
[Abstract]:Based on the thought of different treatment of deficiency and reality and clinical practice, this paper systematically discusses the etiology and pathogenesis of rheumatism, clinical manifestations and treatment methods and prescriptions, and summarizes that the basic cause of rheumatism is deficiency of qi, mainly deficiency of liver and kidney, and so on. Deficiency of yin and blood, deficiency of yang qi and so on, with the invasion of excess evil as standard, pathological factors such as rheumatism, cold and dampness, dampness and heat, blood stasis, phlegm etc. Before treatment, the thought of differentiation of syndrome and treatment should be passed through all the time, mainly to deficiency, but slow to cure the root cause. We should first strengthen the right, and give the methods of tonifying viscera, replenishing qi, nourishing blood, nourishing yin and warming yang respectively, which can be applied to the period of serious deficiency of positive qi and remission of disease. In order to treat the symptoms of the disease, it is necessary to dispel pathogenic factors first, to remove wind and dampness, to clear away heat and dampness, to facilitate urination, to perspire slightly, to activate blood circulation and to clear the veins, and so on, which is suitable for the treatment of the disease at the beginning of the disease and the exacerbation of the chronic disease. According to the degree and amount of deficiency and reality, the treatment principles of strengthening and dispelling evil, dispelling evil and strengthening evil, simultaneously reinforcing the spirit and dispelling evil should be taken respectively. This type is the most common type in clinic. Finally, through enumerating the clinical medical records to deepen the understanding and clinical application of the idea of different treatment of deficiency and reality.
【作者单位】：中国中医科学院望京医院风湿病科;
【基金】：中国中医科学院“名医名家传承”项目(CM2014GD1011)-胡荫奇学术思想与临床经验传承研究
【分类号】：R249;R259

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