叶天士_临证指南医案_辨治咳嗽经验探析.pdfVIP

山 西 中 医 　20 10年 3月第 26卷第 3期 　　　　　 　　　　　SHANX I J OF TCM 　M ar 20 10 Vol26 No3　 ·1 · ·学术探讨 · 叶天士 《临证指南医案 》辨治咳嗽经验探析 张建华 　　摘要 :叶天士 《临证指南医案 ·咳嗽 》中汇集了有关诊治咳嗽的医案 142 例 ,归纳为风寒袭肺 、风热犯肺 、肺燥津伤 、肝火 灼肺 、脾虚肺弱和肺肾虚衰 6型 。通过分析 ,可以看出叶天士治疗咳嗽 ,并非见咳治咳 ,而是善于掌握病因病机 。邪在表者予 轻剂宣解 ,邪在里者或不治肺而治脾肾 ,注重顾护胃气和津液 。充分体现了叶天士辨治咳嗽精深的学术见解与博通丰富的临 证经验 。 关键词 :叶天士 ;临证指南医案 ;咳嗽 ;治法 中图分类号 : R2492　R25611　文献标识码 : A 　文章编号 : 1000 - 7 156 (20 10) 03 - 000 1 - 03 Ana ly sis on Character istic s of YE T ian sh i Trea tin g C ou gh in C lin ica l G u ide to M ed ica l R e ca rds　ZHAN G J ian hua (D a li Coun ty H osp ita l in S hanx i, D a li, 7 15 100, Ch ina) A b stract: C lin ica l Gu ide toM ed ica l R ecords is a co llection of YE T ian sh is succeeding ca se s and p re scrip tion s on variou s disea se s of in ternal m edicine, gyneco logical and p ediatric disea se s. It con tained a total of 142 ca se s re lated to d iagno sis and treatm en t of cough , wh ich were rough ly divided in to six typ e s, w indco ld pu lmonary sthen i a, w indheat pu lmonary sthen ia, con sump tion of body flu id due to lungdryne ss, liver heat invading lung, hypo function of sp leen leading to weakne ss of lung, and deficiency of lung and k idney. By the p re scrip tion s in every ca se, we can see that YE T ian sh i d id not like to k ill the symp tom of cough , bu t gra sp ed the cau se and p athogene sis of cough to k ill cough wh ile he treated it. W hen evil wa s in the exterior, he wou ld select the p re scrip tion for exp elling w indevil to op en the inh ib ited lungenergy. B u t when evil wa s in the in terior, he wou ld not treat lung bu t treat sp leen and k idney, focu sing on p rotecting ga stric qi and body flu id. A ll tho se fu lly reflect YE T ian sh i’s treatm en t characteristic s, m eticu lou s dif