中医临床病证 哮病.pptVIP

Wheezing Syndrome哮 病 杨明山 上海中医药大学教务处 Contents 病名 病因 病机 症候 四诊 辨证 治则 方药 其他 Terminology Etiology Mechanism Manifestation TCM Diagnosis Differentiation Therapy TCM Formulae Others Terminology 病 名 01.《内经?素问?阴阳别论篇》提到“喘鸣” 。 古文：阴争于内阳扰于外，魄汗未藏，四逆而起，起则熏肺，使人喘鸣。 If yin dominates interiorly and yang intrudes exteriorly exteriorly, the soul sweating fails to be stored and the disorders develops all over the body, starting with lung damaged which will lead to wheezing with stridor. 02. 南宋嘉定(1220)王执中《针灸资生经》最早提出“哮喘”之名。 古文：因与人治哮喘，只缪（刺）肺腧，不缪他穴。 Acupoint Feishu more than others is needled to treat asthma. 03. 南宋张杲《医说?卷四》提到“齁喘”。 古文：因食盐虾过多，遂得齁喘之疾。 Taking too much salty fish will lead to asthma due to fish (Houchuan). 04.元朱丹溪首创“哮喘”病名，《丹溪心法》设独立篇名《哮喘十四》；另设《喘十五》；自此喘与哮分别叙述。 It’s the first time to give name “asthma” to this disorder used as the title of one chapter and then to discuss wheezing syndrome and dyspnea syndrome separately. 06. 明朝秦景明在《症因脉治?卷二哮病论》提出“哮病”之病名。 古文：哮病内伤痰饮，外感风寒，合而成。 英文：Wheezing syndrome is caused by both interior phlegm-retention and exterior wind-cold. 05.明虞抟《医学正传?哮喘》区别哮与喘。 古文：哮以声响言，喘以气息言。 We diagnose asthma especially from it’s sound, and diagnose gasping from it’s breath. Terminology 喘： panting 喘鸣：stridor 喘证：gasping syndrome 哮证：wheezing syndrome 哮喘：asthma Etiology 病 因 01《内经?素问?阴阳别论篇》认识到内外因素影响脏功能(尤其是肺)是哮病的主要病机。 古文：阴争于内阳扰于外，魄汗未藏，四逆而起，起则熏肺，使人喘鸣。 If yin dominates interiorly and yang intrudes exteriorly, the soul sweating fails to be stored and the disorders develops all over the body, starting with lung damaged and leading to stridor and wheezing. 02《内经·素问·太阴阳明论》 提出外(风)邪致哮说。 古文：犯贼风虚邪者， …阳受之则入六腑… 入六腑则身热，不时卧，上为喘呼。 It proposed the theory that exogenous evil can cause the illness, “When the body is infected by occult evil wind, … yang six FU-organs are affected if yang is involved, … then the patient has a fever and fails to sleep flat, leading to whooping upward. 03《黄帝内经·灵枢·邪气藏府病形》提出外感“寒邪”之认识。 古文：两寒相感，中外