第五章 中医六郁之说学术源流探析.docVIP

中医“六郁”之说学术源流探析 汪伟 段雷 谭辉 （安徽中医药大学，安徽 合肥 230038） 摘要：朱震亨以人身诸病多起于郁，气郁然后湿、热、痰、血、食相因为病，创立六郁之说，制越鞠丸通治六郁病证。戴原礼在其论治六郁的基础上，提出“六郁责诸中焦”之说，辨治六郁，须分中外风、寒、湿、热四气之不同；王纶在继承其医学思想的基础上，发挥了杂病以气、血、痰、郁论治的观点；龚廷贤在丹溪治郁理论基础上，结合临床补充证治方药，颇具临床应用价值。 关键词：六郁；学术源流；朱震亨；戴原礼；王纶；龚廷贤 On the academic origin of six depression in traditional Chinese Medicine WANG Wei DUAN Lei TAN Hui (Anhui university of traditional Chinese medicine, Hefei 230038) Abstract：Zhu Zhenheng think personal the disease more than in depression, including heat qi depression, wet depression, depression, phlegm yu, blood depression, depression,He founded six Yu theory, the creation of YueJuWan, treatment of six depression syndrome. Zhu Zhenheng put forward Six depression theory. Then, the ancient physicians on the syndrome of stagnation of elucidation of many, extensive content, viewpoint confused is shown, and treatment of the rich. Dai Yuanli on the basis of his theory of six depression,He thinks that the theory should be six Yu wind, cold, wet, heat; Wang Lun played on the treatment of miscellaneous diseases, blood, phlegm, qi stagnation on the basis of his medical thought；Gong Tingxian combined with clinical treatment of prescription on the basis of Zhu Danxis theory of the treatment of depression. This paper aims to summarize Zhu Zhenheng and later doctors about six Yus clinical experience and theory,to further tap the ancient worthies on treating stagnation of academic thoughts, in order to provide reference for modern clinical thinking. Key words：six modes of depression;Zhu Zhenheng;Dai Yuanli;Wang Lun;Gong Tingxian;origin 郁，乃积聚、阻滞之意。在传统医学上，“郁”有广义和狭义之别: 广义之“郁”，多指外邪侵扰、情志不遂、饮食所伤和起居无常等因素所致的“郁”在内；狭义之“郁”即情志之郁，是指以情志不舒为病因,以气机郁滞为病机的“郁”。郁证是由于情志不舒、气机郁滞所致，以心情抑郁、情绪不宁、胸部满闷、胁肋胀痛、或易怒易哭、或咽中如有异物梗阻等为主要临床表现的一类病症[]。《内经》伊始，虽无郁证之名，但有关五气之郁的阐述颇多，对其病因、病机以及治疗法则等论述详尽，不乏卓识之见，奠定了郁证学说理论基础。王冰阐释《内经》五郁之说，引起后世医家诸多争论，从而使得“五郁”理论不断得到充实。元·朱震亨论郁则以“气、湿、热、痰、血、食”立论，系统提出了“六郁”之说，可谓独树一帜，其后他的弟子戴原礼、王纶等人又不断地从理论与临床实践上，大大丰富了丹溪的“六郁”学说。有鉴于此，笔者不物浅陋，试陈管见，对中医六郁理论的学术源流进行整理分析，不妥之处，敬请同道