连建伟教授调五脏治咳嗽经验.docVIP

连建伟教授调五脏治咳嗽经验 ?592?中华中医药杂志(原中国医药学报)2008年7月第23卷第7期CJTCMP,July 2008,Vol.23,No.7[7]太医院.太医院入值官员名册.手抄件.北京:中国第一历史档案馆藏,无朝年The Imperial Medical Academy.Nominal list of officers of theImperial Medical Academy.Beijing:Collected by First HistoricArchivesofChina,yearnotknown[8]洪贵芝，冯亚平.避暑山庄.北京:地质出版社,1996HONG Gui-zhi,FENG Ya-ping.Mountain Resort.Beijing:GeologyPublishingHouse,1996[9]任锡庚.太医院志.石印本.北京:中国中医科学院图书馆藏,1915REN Xi-geng.Annals of the imperial medical academy(stonecarving printed edition).Beijing:Collected by China Academy ofChineseMedicalSciencesLibrary,1915　　(收稿日期：2007年11月6日)·临证经验·“五藏六腑皆令人咳，非独肺也”，出自《素问咳论》，对临床有着深远的指导意义。笔者有幸侍诊方剂学名家连建伟教授，观其治疗咳嗽不拘俗见，临证不仅限于止咳化痰之药，而是察病而知其源，达药而精其方，调达五脏气机，而咳喘自愈。现撷取连师治五脏咳嗽的医案几则，与同道共赏。肺咳《黄帝内经》言：“皮毛者，肺之合也，皮毛先受邪气，邪气以从其合也。其寒饮食入胃，从肺脉上至于肺则肺寒，肺寒则外内合邪，因而客之，则为肺咳”。临床见外感后久咳，多有“外内合邪”，其治法当祛外邪而安其内，忌留邪生变。案例：患者某，男，19岁，2006年8月31日初诊。咳嗽二月余，病起于外感，现咽痒咳嗽，无痰，舌苔薄腻，脉右寸浮，右关大。此为外感风邪挟痰热之咳，拟止嗽散合苇茎汤法。处方：百部10g，白前10g，化橘红6g，桔梗6g，甘草5g，炙紫菀10g，芦根30g，杏仁10g，薏苡仁30g，冬瓜子12g，浙贝母10g，桑叶10g。不到10剂而咳嗽大减，复诊时前方加味，又服数剂而愈。此例久咳，前医因其病程长而考虑内伤，治以养阴法而未愈。连师经过细致的脉诊，查右脉寸浮关连建伟教授调五脏治咳嗽经验孙文斌1（指导：连建伟2）（1舟山市普陀区中医院，舟山316100；2浙江中医药大学，杭州310053）摘要：五脏病变皆可致咳的理论，《黄帝内经》早有阐述，后世名家也多有发挥，对指导临床实践具有深远意义。连建伟教授治疗咳嗽尤其是久咳，多从调理五脏气机着手，以逍遥散治疗肝咳或以复脉汤治疗心咳等，皆自本源入手而疗效明显。文章择其调五脏治咳嗽验案进行分析，有助于古代医理实用性的继承与发展。关键词：五脏咳；调理五脏；医案；连建伟Professor LIAN Jian-wei,s experience on regulating five zang-organs to cure coughSUN Wen-bin1(Director：LIAN Jian-wei2)（1Putuo Hospital of TCM,Zhoushan 316100,China;2Zhejiang University of TCM,Hangzhou 310053，China）Abstract:There was the theory that all the disorders of the ve zang-organs can cause cough originated from InnerCanon of Huangdi.Many famous experts in ancient times developed the theory,which is important in guiding the clinical practice.Professor LIAN always treats cough,especially chronic cough from regulating qi activity of five zang-organs.For example,Xiaoyao powder for cough due to liver disorder,Fumai decoction for cough due to heart disorder,and so on.The curative e ect isremarkable because the trea