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叶天士开宣肺痹法内涵探微

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肺主一身之气,禀清肃之体.若浊邪凝滞,肺气痹阻,扰及周身,可见咳喘、憋闷、呃逆、呕恶、痞胀、二便不通等多脏腑病症.叶天士独创开宣肺痹法,其常法有三,清内伤外感之邪以畅肺气、清肺卫、通肺络;其变法有三,清上焦肺痹以和中焦胃气、通大肠腑气、行膀胱水气.叶天士开宣肺痹法用药特点鲜明,苦辛轻剂合化以复肺气宣肃,取药材表皮、嫩心与药汁以使轻清气药上浮于肺,取柔润通行之品护娇脏之体.叶天士处方用药灵活多变,临证可宗其开宣肺痹法随证发挥.
Preliminary exploration of Ye Tianshi's methods of opening and ventilating lung bi
The lungs govern the body's qi and possess a depurative descending nature.If turbid pathogenic factors accumulate in them and obstruct the lung qi,lung bi develops and affects the whole body,leading to symptoms such as coughing,wheezing,chest tightness,belching,nausea,distention,difficult urination and constipation.Ye Tianshi,a famous physician in the Qing Dynasty,creates the methods of opening and ventilating lung bi,with the regular methods including clearing internal damages and external pathogenic factors to smooth lung qi,clearing lung-defense phase,and opening lung collaterals,while its three modified treatment methods involving clearing the upper energizer lung bi to harmonize the middle energizer stomach qi,promoting the large intestine qi circulation,and facilitating the bladder fluid circulation.In addition,his methods of opening and ventilating lung bi show distinctive medication characteristics.Firstly,the combination of bitter and pungent herbs in mild doses is used to restore lung qi and promote its dispersion and descent.Secondly,herb peels,tender cores and herbal juice are used to allow light depurative herbs to float up to the lungs.Thirdly,gentle and moistening herbs are selected to protect delicate zang-organs.Ye Tianshi's prescription and medication approaches are flexible and variable,allowing for individualized applications based on his methods and the specific symptoms in clinical practice.

Ye GuiGuide to Clinical Practice with Medical Recordsdysfunction of lung qi

张莉唯、付守强、朱晓云、刘喜明

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北京中医药大学,北京 100029

中国中医科学院广安门医院,北京 100053

叶桂 《临证指南医案》 肺气郁痹

北京市科技计划项目

D08050703020803

2024

吉林中医药
长春中医药大学

吉林中医药

CSTPCD
影响因子:0.843
ISSN:1003-5699
年,卷(期):2024.44(1)
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