吴耀南治疗胃病学术思想及临床经验

CJI (Traditional Chinese Medicine) - - 中国中医药信息杂志 -

王芸素,指导:吴耀南

福建中医药大学附属厦门中医院,福建 厦门 361009摘要:本文总结了吴耀南教授治疗胃病的学术思想及临床经验,详细论述其提出的“五脏六腑皆令胃病,非独胃也”的独特学术思想及其创立的“治胃要治心”“治胃要治肺”“治胃要治肝”“治胃要治脾”“治胃要治肾”“治胃要治胆”“治胃要治肠”“治胃要治膀胱”“治胃要治咽”“治胃要治腰”的系列理论和治法用药。关键词:名医经验;吴耀南;胃病;中医药疗法

DOI:10.3969/j.issn.1005-5304.2017.09.026

中图分类号:R259.73 文献标识码:A 文章编号:1005-5304(2017)09-0103-03

Academic Thoughts and Clinical Experience of WU Yao-nan in Treating Stomach Diseases

WANG Yun-su, Instructor: WU Yao-nan (Xiamen Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Chinese Medicine, Xiamen 361009, China)

Abstract: This article summarized academic ideas and clinical experience of Professor WU Yao-nan in treating stomach diseases, expounded and proposed the idea of “stomach diseases not only result from the stomach but also the viscera” and built a series of theories, treatment and medication, which were “to cure the stomach is to cure the heart”, “to cure the stomach is to cure the lungs”, “to cure the stomach is to cure the liver”, “to cure the stomach is to cure the spleen”, “to cure the stomach is to cure the gallbladder”, “to cure the stomach is to cure the intestines”, “to cure the stomach is to cure the bladder”, “to cure the stomach is to cure the pharynx” and “to cure the stomach is to cure the waist”.

Key words: experience of famous foctors; WU Yao-nan; stomach diseases; TCM therapy

吴耀南教授为福建省第三批老中医药专家学术经验继承工作指导老师、首届全国200 名优秀中医临床人才,从事中医脾胃病研究 40 余年,临证经验丰富。吴教授汲取各家脾胃学说精华,以“脾胃者,仓廪之官”(《素问•灵兰秘典论篇》)及“善治病者,唯在调理脾胃”(《脾胃论》)为理论依据,结合自己多年对脾胃病研究和临床实践,根据中医整体观的理论,受《素问•咳论篇》“五脏六腑皆令人咳,非独肺也”启发,提出“五脏六腑皆令胃病,非独胃也”的学术思想,创立“治胃病十法”的系列理论和相应的治法用药,开拓和创新了中医脾胃学说。作为吴教授学术继承人,笔者跟师临证多年,收获颇丰,现将其“治胃病十法”的学术思想详细论述如下。

1 治胃要治心

吴教授认为,火不足则不能生土,故治疗胃病可从心论治。心居膈上,胃居膈下,二者仅一膜之膈,如《医法圆通》谓:“心居膈膜之上,下一寸即胃口,胃口离心不远。”《素问•平人气象论篇》“胃之大络, 名曰虚里,贯膈络肺,出于左乳下,其动应衣,脉宗气也”及《重订通俗伤寒论》“胃之支脉,上络心脑”,明确指出“胃络通心”。胃属土,心属火,火生土,胃土必得心火温煦才能生化不息。心气依赖脾胃化生的宗气以资助,心血赖脾胃化生的营气以充养。

吴教授认为,胃痛日久,导致心不藏神,出现心病症状,心病亦可表现为胃系症状,两者互为因果,出现一种疾病2组症状,临床主要表现为胃脘疼痛、痞满不适、呃逆嘈杂、恶心呕吐,同时兼有胸闷心悸、甚则心痛、重则彻背、面白汗出、头昏乏力。对此病证,吴教授常用心胃同治方:黄芪、丹参、砂仁、檀香、藕节、郁金、枇杷叶、茯神、法半夏、鸡内金、草珊瑚、甘草。或在治疗胃病基础上加用心系药物,如偏心阳不振者,加桂枝甘草汤温通心阳;阳虚重者,再加制附子、干姜;心悸兼反酸者,加珍珠母、黄连、吴茱萸;偏气阴虚者,加太子参、麦冬、五味子;虚阳浮亢者,加黄连、肉桂;瘀滞较甚,加莪术、失笑散;瘀血凝滞,当搜剔络脉,酌加水蛭、全蝎或血竭之类。

2 治胃要治肺

肺不宣降则胃气不降,故治胃病时,可从肺论治。《素问•咳论篇》有“聚于胃,关于肺”,表明肺胃相

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