陈士铎辨治痿症临证经验和特色探析
Journal of Zhejiang Chinese Medical University(2023)
Abstract
[目的]探析陈士铎治痿经验及用药特色,以期为痿症的临床辨治提供新思路.[方法]通过研习《辨证录》痿症门的八则医案,并借助《石室秘录》及《本草新编》中有关痿症的方药论述加以理解分析,从而总结归纳陈士铎对痿症的分类、病因病机、治则治法及方药配伍等方面的经验特色.[结果]陈士铎将痿症分为五痿,分属五脏,医案详症略脉,重视从症状入手定位病脏.病因首推阳明胃火,五脏痿症因脏腑相关及五行生克特点而病机各异,但本质皆为肾水不足,骨空无髓.临床治疗上,陈氏主张从胃肾出发,遵循泻胃火、滋肾水,兼顾他脏的原则,强调忌大寒泻火,宜微寒散火,同时大补肾阴、和调脏腑.用药上,陈氏重用玄参、麦冬为君,配以熟地黄,并善用甘菊花清退胃火.[结论]陈士铎诊治痿症多有效验,并极具个人特色,在汲取前人思想精华的基础上,常有自己的新见解,值得后世借鉴与参考.
MoreKey words
CHEN Shiduo,flaccidity syndrome,Bianzheng Lu,clinical experience,medication characteristic,visceral correlation,generation-inhibition in five elements
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