首页|吴鞠通活用通守法辨治脾胃病探析

吴鞠通活用通守法辨治脾胃病探析

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吴鞠通继承叶天士脾胃分治思想,发展叶天士通守理论,结合自己丰富的临床实践,灵活运用通守法辨治脾胃病.脾胃体用各殊,生理特点不同,即"脾以守为补""胃以通为补",通守法指通补、通运、守补,是顺应脾胃生理特性之治法.中焦虚弱时,则守补脾脏,通补胃腑,脾胃两虚时,通补守补并用;中焦实证,宜用通运;中焦虚实错杂证,则活用通守.通守治法之常法有纯用通运、纯用守补、纯用通补、通守并用,吴鞠通以四君子汤为例,指出守补、通补用药之区别和灵活运用;通守治法之变法有以守作通、以通作守、先守后通、先通后守,视病情以通权达变.通守法拓展了治疗脾胃病的思路,于临床更有效.
Exploration of WU Jutong's flexible use of Tongshou method in the treatment of spleen and stomach diseases
WU Jutong inherited YE Tianshi's thought of treating spleen and stomach separately.He developed YE Tianshi's theory of Tongshou.Combined with his rich clinical practice,he flexibly used the method of Tongshou to treat spleen and stomach diseases.The spleen and stomach have different body and function.The physiological characteristics of spleen and stomach are different.That is,'benefiting spleen with the method of tonifying''benefiting stomach with the method of dredging'.The method of Tongshou refers to the method of tonifying combining with dredging,dredging method,and tonifying method.It is a treatment that conforms to the physiological characteristics of the spleen and stomach.If the middle jiao is weak,the spleen should be tonified and the stomach should be tonified combining with dredging.When the spleen and stomach are both deficient,tonifying method and the method of tonifying combining with dredging should be used together.When the middle jiao has excess syndrome,it is appropriate to use dredging method.When the middle jiao has syndrome of intermingled deficiency and excess,it is appropriate to use dredging or tonifying method flexibly.The common methods of treatment include pure dredging,pure tonifying,pure tonifying combining with dredging,and using both dredging and tonifying.Taking Sijunzi Decoction as an example,WU Jutong pointed out the difference and flexible use of medication in pure tonifying and pure tonifying combining with dredging.The reform methods of treatment include taking tonifying as dredging,taking dredging as tonifying,tonifying first and then dredging,and dredging first and then tonifying.It is necessary to accommodate the method of Tongshou to patients'condition.The method of Tongshou expands the idea of treating spleen and stomach diseases and is more effective in clinical practice.

WU JutongMethod of TongshouMethod of tonifying combining with dredgingDredging methodTonifying methodSpleen and stomach diseasesTreatment based on symdrome differentiation

晏蔓柔、李楠、钱琳琳、付静思、马晓北

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中国中医科学院中医基础理论研究所,北京 100700

中国中医科学院研究生院,北京 100700

吴鞠通 通守法 通补 通运 守补 脾胃病 辨证论治

国家中医药管理局《中华医藏》编纂项目中国中医科学院科技创新工程重大攻关项目

GZY-KJS-2021-066CI2021A00103

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(9)