从肝论治百合病OA
Discussion on the Treatment of Lily Disease from the Perspective of Liver
百合病最早见于《金匮要略》:"百合病,百脉一宗,悉致其病也."百合病是一种表现为精神恍惚、精神不定的情志病,在治疗时又以百合为主药,因而称之百合病.此病起于伤寒大病之后,余热未解,或患者平素即情志不遂,而遇外界精神刺激所致.在对于百合病的认识上,虽然不同医家见解不同,但是众多医家基于"百合病者,百脉一宗,悉致其病也",鉴于百脉一宗指的是人体所有的血脉与经脉,心肺包括其中,从而认为百合病的病机与心肺密不可分,即其病机为心肺阴虚内热.不过从心肺论治百合病,其情志、饮食等相关症状无法得到准确解释,患者之肺、脾见证无法互相关联,若是从肝论治百合病则能更好地解释百合病神志异常及肺、脾见证.作者首先从经脉循行探讨该病与肝经的关系,其次根据百合病的相关症状分析其与肝的内在联系,进而推测百合病为肝经有余热所导致,再结合章节撰写规律进一步探讨百合病与肝经余热的关系.此外通过百合病主要症状及次要症状,解释肝经有余热深浅不同时,百合病疾病进程的时间亦有所不同.通过对百合与肝经余热关系的探讨,在治疗时根据疾病的特点,得出百合病主方百合地黄汤之作用为清除肝经之余热,在百合病的诊疗过程中应该尽早调治并清余热,同时治疗时亦可根据其情志相关的表现,条畅情志加以疏肝.
Lily disease was first seen in the"Golden Chamber Essentials":"Lily disease,all the meridians are one,all the diseases are caused."Lily disease is an emotional disease characterized by mental confusion and mental insta-bility.Lily is the main medicine for treatment,so it is called lily disease.This disease occurs after a serious illness of typhoid fever,when the residual heat has not been resolved,or the patient's emotions are usually frustrated,and it is caused by external mental stimulation.Although different doctors have different views on lily disease,many doctors be-lieve that the pathogenesis of lily disease is inseparable from the heart and lungs based on the fact that"lily disease,all the meridians are one,all the diseases are caused".Since all the meridians refer to all the blood vessels and meridians in the human body,including the heart and lungs,they believe that the pathogenesis of lily disease is inseparable from the heart and lungs,that is,its pathogenesis is heart and lung yin deficiency and internal heat.However,if lily disease is treated from the perspective of the heart and lungs,its emotional,diet and other related symptoms cannot be accu-rately explained,and the patient's lung and spleen symptoms cannot be related to each other.If lily disease is treated from the perspective of the liver,the abnormal mental state and lung and spleen symptoms of lily disease can be better explained.The author first discusses the relationship between this disease and the liver meridian from the perspective of meridian circulation.Secondly,based on the relevant symptoms of lily disease,the author analyzes its internal con-nection with the liver,and then speculates that lily disease is caused by residual heat in the liver meridian.Then,the author further discusses the relationship between lily disease and residual heat in the liver meridian in combination with the chapter writing rules.In addition,through the main and secondary symptoms of lily disease,it is explained that when the depth of residual heat in the liver meridian is different,the duration of the disease process of lily disease is also different.Through the discussion of the relationship between lily and residual heat in the liver meridian,accord-ing to the characteristics of the disease during treatment,it is concluded that the main prescription of lily disease,Lily Rehmannia Decoction,is to clear the residual heat in the liver meridian.In the diagnosis and treatment of lily disease,it should be adjusted and cleared as soon as possible.At the same time,according to the manifestations related to emo-tions,the liver can be relieved by smoothing emotions.
任鹏;孙凤
黑龙江省中医药科学院研究生院 黑龙江哈尔滨 150036黑龙江中医药大学附属第一医院 黑龙江哈尔滨 150040
中医学
百合病从肝论治肝经余热
Lily diseaseTreatment from the liverResidual heat in the liver meridian
《中医药临床杂志》 2024 (008)
1508-1512 / 5
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