叶天士"渗"法内涵新考与临床探赜
Global Traditional Chinese Medicine(2023)
Abstract
"渗湿于热下"源自叶天士《温热论》.在外感温病邪气初犯肺卫的阶段,多数医家普遍以"或透风于热外,或渗湿于热下"为治疗准则."透"法以透解邪热为主,"渗"法多指渗利湿热,但"渗"之寓意不止于治疗外感湿热病邪,更可以"渗法"之名应用于内伤杂病的治疗中,拓展临床症治范围.本文新考"渗"湿本义,从温病领域阐述"渗"法的病势特点,"趋势向下""针对湿""透""渗"有先后等方面,是对中医临床思维的再启发.并以《临证指南医案》为基,总结叶天士淡渗用药特点以体现"渗湿于热下"新思考下的临床验案实例.结论为"渗湿于热下"纲领性理论是依据湿邪性质得出的,应举"甘淡"之味,以通利为宗,浑圆气机,欲得邪解病痊之果.希冀有助于医者提高温病理论认识并扩展临床应用度.
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