浙江中医药大学学报2026，Vol.50Issue(3)：319-324,6.DOI:10.16466/j.issn1005-5509.2026.03.007
叶天士宣透上焦法在新型冠状病毒感染后遗症之痞证中的运用
Application of YE Tianshi's Method of Dispersing the Upper-Jiao in the Treatment of Epigastric Fullness of COVID-19 Infec-tion Sequela
摘要
Abstract
[Objective]To introduce YE Tianshi's experience in the diagnosis and treatment of epigastric fullness by dispersing the upper-Jiao,and explore the feasibility of applying this method to treat epigastric fullness of Corona Virus Disease 2019(COVID-19)infection sequela.[Methods]By clarifying the concept of YE Tianshi's method of treating epigastric fullness by dispersing the upper-Jiao,rectifying its connotation,and further elaborating on it in combination with Clinic Guideline of Medical Records,the experience of YE Tianshi in the diagnosis and treatment of epigastric fullness by dispersing the upper-Jiao was analyzed.Meanwhile,by sorting out traditional Chinese medicine(TCM)principles and methods of epigastric fullness of COVID-19 infection sequela,and providing clinical medical records,the feasibility of applying dispersing the upper-Jiao method to treat epigastric fullness of COVID-19 infection sequela was explored.[Results]It was found that YE Tianshi extraordinarily paid attention to dispersing the Qi movement in upper-Jiao when treating the epigastric fullness,and according to Clinic Guideline of Medical Records,the relevant method includes two aspects:aromatic medicine opening Qi depression and cold-pungent and diaphoretic drugs dispersing fire.The former is mostly used to take Amomi Kravanh Fructus,Semen Armeniacae Amarum,Tangerine cortices and other mild bitter and mild flowing products.The latter is used for the epigastric fullness of Qi stagnation with fire,and classical prescription Zhizichi Decoction is the core formula to treat this type.The fundamental pathogenesis of epigastric fullness of COVID-19 infection sequela lies in the failure of lung Qi to diffuse,with dampness oppression and latent heat being important contributing factors.Therefore,the treatment can consider YE Tianshi's method of dispersing the upper-Jiao.The attached case was an epigastric fullness formed after COVID-19 infection due to the stagnation of lung Qi in the upper-Jiao,which generated heat and phlegm,and affected the ascending and descending mechanism of the middle-Jiao.The treatment method was to use pungent and cool substances to clear and diffuse the latent heat,and the therapeutic effect was quite good.[Conclusion]The method of dispersing the upper-Jiao is a unique experience of YE Tianshi in the treatment of epigastric fullness,which is a vivid embodiment of the overall and interconnected perspective of TCM in the diagnosis and treatment of diseases.Summarizing YE Tianshi's experience in the diagnosis and treatment of epigastric fullness by dispersing the upper-Jiao,not only directly improves the relevant research on YE Tianshi's academic experience,but also offers valuable insights and references for the clinical treatment of sequelae of COVID-19.关键词
宣透上焦/痞证/新冠后遗症/湿遏热郁/《临证指南医案》/叶天士/温病/医案Key words
dispersing the upper-Jiao/epigastric fullness/sequelae of COVID-19/dampness repression and heat depression/Clinic Guideline of Medical Records/YE Tianshi/febrile disease/medical records分类
医药卫生引用本文复制引用
沈祥峰,金禹衡,金城钟,司鹏飞..叶天士宣透上焦法在新型冠状病毒感染后遗症之痞证中的运用[J].浙江中医药大学学报,2026,50(3):319-324,6.基金项目
浙江省社科联年度项目(2022N35) （2022N35）
浙江省中医药科研基金项目(2022ZB290) Annual Project of Zhejiang Federation of Humanities and Social Sciences(2022N35) （2022ZB290）
Zhejiang Traditional Chinese Medicine Scientific Research Fund Project(2022ZB290) （2022ZB290）
