从肝主疏泄辨治杂病
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摘要
肝主疏泄,疏可使气运行通而不滞;泄可使气散而不郁,调畅全身气机运行;肝失疏泄,气机运行不畅则可致多种疾病。气是构成和维持人体生命活动的最基本物质。"百病生于气",疾病多因脏腑经脉气机失调。消化系统可见胃黏膜糜烂,肝气疏泄失常,气血运行不畅,胃部黏膜失养而出现糜烂,治以逍遥散或丹栀逍遥散化裁;情志不畅还可引发胆汁排泄障碍,出现胆系疾病,治以疏肝利胆、养肝柔肝,小柴胡汤。妇科疾病如乳腺增生、子宫肌瘤与情绪失调密切相关,肝在女子生理、病理中的重要作用,应激能力失常,导致乳腺增生或子宫肌瘤,治以逍遥散、神效瓜蒌散、当归芍药散。内分泌受下丘脑中枢神经系统调节,情志不遂可导致内分泌失常,发生糖尿病、甲状腺结节等,治疗注重疏肝、调肝、柔肝、养肝,乌梅丸、柴胡舒肝散。从肝论治,紧抓肝失疏泄这一病机,以疏肝解郁为法,则气血调和,经络通利,诸病得治。
The liver main venting, so that Qi can run through without stagnation; venting can make the Qi disperse without stagnation, and regulate the whole body machine operation; liver loss and suffocation, the Qi machine running poorly can cause a variety of diseases. Qi is the most basic substance that constitutes and maintains human life activities. "All diseases are born in the Qi", the disease is mostly due to dysfunction of the organs of the organs. The digestive system can be seen in the gastric mucosal erosion, the liver Qi is dysfunctional, the blood and blood are not running smoothly, the gastric mucosa is dying and there is erosion,and it is treated with Xiaoyao powder(逍遥散) or Danzhi Xiaoyao powder(丹栀逍遥散). Unsatisfactory emotions can also cause bile excretion disorders, biliary diseases, treatment of liver and gallbladder, nourishing liver and liver, Xiaochaihu decoction(小柴胡汤). Gynecological diseases such as breast hyperplasia, uterine fibroids and emotional disorders are closely related, the liver plays an important role in women's physiology and pathology,and the stress ability is abnormal, leading to breast hyperplasia or uterine fibroids, Governance with Xiaoyao powder(逍遥散), Shenxiao Gualou powder(神效瓜蒌散), Danggui Shaoyao powder(当归芍药散). Endocrine regulation by the central nervous system of the hypothalamus can lead to endocrine disorders, diabetes,thyroid nodules, etc. The treatment focuses on soothing the liver, regulating the liver, softening the liver,nourishing the liver, Wumei pill(乌梅丸), Chaihu Shugan powder(柴胡疏肝散). From the treatment of the liver, grasping the pathogenesis of liver loss and stagnation, with the method of soothing the liver and relieving depression, the qi and blood are harmonious, the meridian is profitable, and the diseases are cured.
The liver main venting, so that Qi can run through without stagnation; venting can make the Qi disperse without stagnation, and regulate the whole body machine operation; liver loss and suffocation, the Qi machine running poorly can cause a variety of diseases. Qi is the most basic substance that constitutes and maintains human life activities. "All diseases are born in the Qi", the disease is mostly due to dysfunction of the organs of the organs. The digestive system can be seen in the gastric mucosal erosion, the liver Qi is dysfunctional, the blood and blood are not running smoothly, the gastric mucosa is dying and there is erosion,and it is treated with Xiaoyao powder(逍遥散) or Danzhi Xiaoyao powder(丹栀逍遥散). Unsatisfactory emotions can also cause bile excretion disorders, biliary diseases, treatment of liver and gallbladder, nourishing liver and liver, Xiaochaihu decoction(小柴胡汤). Gynecological diseases such as breast hyperplasia, uterine fibroids and emotional disorders are closely related, the liver plays an important role in women's physiology and pathology,and the stress ability is abnormal, leading to breast hyperplasia or uterine fibroids, Governance with Xiaoyao powder(逍遥散), Shenxiao Gualou powder(神效瓜蒌散), Danggui Shaoyao powder(当归芍药散). Endocrine regulation by the central nervous system of the hypothalamus can lead to endocrine disorders, diabetes,thyroid nodules, etc. The treatment focuses on soothing the liver, regulating the liver, softening the liver,nourishing the liver, Wumei pill(乌梅丸), Chaihu Shugan powder(柴胡疏肝散). From the treatment of the liver, grasping the pathogenesis of liver loss and stagnation, with the method of soothing the liver and relieving depression, the qi and blood are harmonious, the meridian is profitable, and the diseases are cured.
引文
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[2]刘艳丽,王秀秀,韩金祥.中医“气”学说研究60年[J].辽宁中医杂志,2014,41(11):2299-2303.
[3]苏维霞.《脾胃论》胃病证治规律研究[D].银川:宁夏医科大学,2012.
[4]殷美琦,王光耀.浅议“肝为五脏之贼”[J].中国中医药现代远程教育,2010,8(18):3.
[5]潘立文,王晓明.“肝为五脏之贼”的临床应用探析[J].中医药导报,2017,23(12):118-123.
[6]黄帝内经素问[M].北京:人民卫生出版社,2012.
[7]吴丹.张介宾论治郁证思想研究[D].北京:北京中医药大学,2012.
[8]林迪卫.许鑫梅教授治疗胃痛的经验总结[D].广州:广州中医药大学,2013.
[9]张永生.上消化道出血病因分析及相关因素研究[D].济南:山东大学,2009.
[10]薛亚妮,廖莉,陈道荣.蒙脱石散对急性胃黏膜病变的修复作用及其机制[J].中国医院药学杂志,2015,35(10):911-916.
[11]朱昱翎,白宇宁,姚乃礼.从“脾虚络阻毒损”认识胃癌前病变胃黏膜屏障损伤及其辨治思路[J]中医杂志,2013,54(10):817-820.
[12]张九重.气机郁滞与疾病发生模式的探讨[J].中国中西医结合急救杂志,1999,6(5):196.
[13]刘蓉,黄灿灿,郝征.从脏腑虚寒证辨治口苦[J]浙江中医杂志,2017,52(7):518-519.
[14]灵枢经[M].北京:人民卫生出版社,2012.
[15]张媚.胆腑与利胆[J].河北中西医结合杂志,1996,5(1):106.
[16]王玉芳.浅谈肝为“将军之官”[J].中国中医药现代远程教育,2011,9(4):6-7.
[17]朱培庭.胆石病“从肝论治”要点[J].上海中医药大学学报,2007,21(6):1-3.
[18]肇晖.胆病从肝论治医药携手创新[J].上海医药,2016,37(11):1-2.
[19]陈明.“凡十一脏取决于胆”纵横谈[J].北京中医药大学学报,1994,17(1):14-16.
[20]李金霞,赵文华,张秋云.《金匮要略》酸甘焦苦理论发挥[J].环球中医药,2015,8(5):565-567.
[21]马珊珊,呼敏,王荣.论“女子以肝为先天”在叶天士妇科病治疗中的应用[J].陕西中医药大学学报,2016,39(1):25-27.
[22]孙思邈.备急千金要方校释[M].李景荣,校释.北京:人民卫生出版社,1998:21.
[23]董敏,潘文,王晓萍,等.乳腺增生症与乳腺癌中医病因病机探析[J].中国中医基础医学杂志,2013,19(1):18-19.
[24]李荣娟,葛建立,张欣,等.耳压拔罐联合治疗早期乳痈临床研究[J].河北中医药学报,2015,30(3):50-52.
[25]刘小辉,王颂,丛慧芳.厥阴肝经循行在妇科临床中的指导意义[J].黑龙江中医药,2014,43(1):7-8.
[26]吴雪雪,杨毅,时光喜.姜兆俊从肾虚论治乳腺增生病经验[J].实用中医药杂志,2013,29(12):1056.
[27]林毅,唐汉钧.现代中医乳房病学[M].北京:人民卫生出版社,2003:104.
[28]王勇,陈超.归参胶囊对乳腺增生病大鼠激素水平的影响[J].中国临床康复,2005,9(14):162-163.
[29]龚廷贤.寿世保元[M].天津:天津科学技术出版社,2011:551.
[30]侯苹.子宫肌瘤微环境中炎症因子及激素与纤维化的相关研究[D].昆明:昆明理工大学,2016.
[31]王伟红.雌二醇代谢产物对肝星状细胞增殖和TGF-β1、CTGF表达的影响[D].长沙:中南大学,2008.
[32]竹剑平,董襄国.唐容川从肝论治血证浅析[J].贵阳中医学院学报,1984(4):54-55.
[33]吴瑭.吴鞠通医案[M].北京:中国医药科技出版社,2012.
[34]张仲景.金匮要略[M].北京:中国医药科技出版社,2012:312.
[35]叶颖.吕绍光主任从肝论治与内分泌疾病有关的眩晕病经验[J].福建中医药,2014,45(6):23-25.
[36]肖然.中医药治疗糖尿病的临床研究[J].中国当代医药,2015,22(16):12-14.
[37]陶晓雯,雷正权.从厥阴病论治颈源性眩晕[J].亚太传统医药,2017,13(16):39-40.
[38]叶天士.叶天士医学全书[M].北京:中国中医药出版社,1996:164.
[39]董妍妍,储全根.叶天士从肝论治消渴病初探[J].安徽中医学院学报,2013,32(1):1-2.
[40]李楠,徐正婕.肝病中肝脏糖脂代谢的相互作用[J].肝脏,2012,17(10):730-731.
[41]张冠杰,路波.路波从厥阴辨治消渴病经验举隅[J].山西中医,2013,29(11):8-9.
[42]胡波.施今墨方加减治疗2型糖尿病30例[J].河南中医,2007,27(1):54-55.
[43]郭风.中药外敷治疗良性单纯性甲状腺结节的临床疗效观察[D].哈尔滨:黑龙江中医药大学,2017.
[44]叶玉峰,江潮,邵迎新,等.益气化瘀法在自身免疫性甲状腺疾病中的应用[J].中国医药导报,2016,13(10):80-83.
[45]武西芳.滋肾消瘿化瘀汤治疗甲状腺结节62例[J].中医研究,2018,31(8):22-23.
[46]傅杰,龚淑芳.甘麦大枣汤在甲亢病中运用体会[J].江西中医药,2011,42(4):31.
[47]曹琳.余江毅教授从肝论治甲状腺结节经验精萃[J].辽宁中医药大学学报,2010,12(10):124-125.
[48]姜德友,曲晓雪.瘿病的中医证治[J].河南中医,2016,36(7):1237-1239.
[2]刘艳丽,王秀秀,韩金祥.中医“气”学说研究60年[J].辽宁中医杂志,2014,41(11):2299-2303.
[3]苏维霞.《脾胃论》胃病证治规律研究[D].银川:宁夏医科大学,2012.
[4]殷美琦,王光耀.浅议“肝为五脏之贼”[J].中国中医药现代远程教育,2010,8(18):3.
[5]潘立文,王晓明.“肝为五脏之贼”的临床应用探析[J].中医药导报,2017,23(12):118-123.
[6]黄帝内经素问[M].北京:人民卫生出版社,2012.
[7]吴丹.张介宾论治郁证思想研究[D].北京:北京中医药大学,2012.
[8]林迪卫.许鑫梅教授治疗胃痛的经验总结[D].广州:广州中医药大学,2013.
[9]张永生.上消化道出血病因分析及相关因素研究[D].济南:山东大学,2009.
[10]薛亚妮,廖莉,陈道荣.蒙脱石散对急性胃黏膜病变的修复作用及其机制[J].中国医院药学杂志,2015,35(10):911-916.
[11]朱昱翎,白宇宁,姚乃礼.从“脾虚络阻毒损”认识胃癌前病变胃黏膜屏障损伤及其辨治思路[J]中医杂志,2013,54(10):817-820.
[12]张九重.气机郁滞与疾病发生模式的探讨[J].中国中西医结合急救杂志,1999,6(5):196.
[13]刘蓉,黄灿灿,郝征.从脏腑虚寒证辨治口苦[J]浙江中医杂志,2017,52(7):518-519.
[14]灵枢经[M].北京:人民卫生出版社,2012.
[15]张媚.胆腑与利胆[J].河北中西医结合杂志,1996,5(1):106.
[16]王玉芳.浅谈肝为“将军之官”[J].中国中医药现代远程教育,2011,9(4):6-7.
[17]朱培庭.胆石病“从肝论治”要点[J].上海中医药大学学报,2007,21(6):1-3.
[18]肇晖.胆病从肝论治医药携手创新[J].上海医药,2016,37(11):1-2.
[19]陈明.“凡十一脏取决于胆”纵横谈[J].北京中医药大学学报,1994,17(1):14-16.
[20]李金霞,赵文华,张秋云.《金匮要略》酸甘焦苦理论发挥[J].环球中医药,2015,8(5):565-567.
[21]马珊珊,呼敏,王荣.论“女子以肝为先天”在叶天士妇科病治疗中的应用[J].陕西中医药大学学报,2016,39(1):25-27.
[22]孙思邈.备急千金要方校释[M].李景荣,校释.北京:人民卫生出版社,1998:21.
[23]董敏,潘文,王晓萍,等.乳腺增生症与乳腺癌中医病因病机探析[J].中国中医基础医学杂志,2013,19(1):18-19.
[24]李荣娟,葛建立,张欣,等.耳压拔罐联合治疗早期乳痈临床研究[J].河北中医药学报,2015,30(3):50-52.
[25]刘小辉,王颂,丛慧芳.厥阴肝经循行在妇科临床中的指导意义[J].黑龙江中医药,2014,43(1):7-8.
[26]吴雪雪,杨毅,时光喜.姜兆俊从肾虚论治乳腺增生病经验[J].实用中医药杂志,2013,29(12):1056.
[27]林毅,唐汉钧.现代中医乳房病学[M].北京:人民卫生出版社,2003:104.
[28]王勇,陈超.归参胶囊对乳腺增生病大鼠激素水平的影响[J].中国临床康复,2005,9(14):162-163.
[29]龚廷贤.寿世保元[M].天津:天津科学技术出版社,2011:551.
[30]侯苹.子宫肌瘤微环境中炎症因子及激素与纤维化的相关研究[D].昆明:昆明理工大学,2016.
[31]王伟红.雌二醇代谢产物对肝星状细胞增殖和TGF-β1、CTGF表达的影响[D].长沙:中南大学,2008.
[32]竹剑平,董襄国.唐容川从肝论治血证浅析[J].贵阳中医学院学报,1984(4):54-55.
[33]吴瑭.吴鞠通医案[M].北京:中国医药科技出版社,2012.
[34]张仲景.金匮要略[M].北京:中国医药科技出版社,2012:312.
[35]叶颖.吕绍光主任从肝论治与内分泌疾病有关的眩晕病经验[J].福建中医药,2014,45(6):23-25.
[36]肖然.中医药治疗糖尿病的临床研究[J].中国当代医药,2015,22(16):12-14.
[37]陶晓雯,雷正权.从厥阴病论治颈源性眩晕[J].亚太传统医药,2017,13(16):39-40.
[38]叶天士.叶天士医学全书[M].北京:中国中医药出版社,1996:164.
[39]董妍妍,储全根.叶天士从肝论治消渴病初探[J].安徽中医学院学报,2013,32(1):1-2.
[40]李楠,徐正婕.肝病中肝脏糖脂代谢的相互作用[J].肝脏,2012,17(10):730-731.
[41]张冠杰,路波.路波从厥阴辨治消渴病经验举隅[J].山西中医,2013,29(11):8-9.
[42]胡波.施今墨方加减治疗2型糖尿病30例[J].河南中医,2007,27(1):54-55.
[43]郭风.中药外敷治疗良性单纯性甲状腺结节的临床疗效观察[D].哈尔滨:黑龙江中医药大学,2017.
[44]叶玉峰,江潮,邵迎新,等.益气化瘀法在自身免疫性甲状腺疾病中的应用[J].中国医药导报,2016,13(10):80-83.
[45]武西芳.滋肾消瘿化瘀汤治疗甲状腺结节62例[J].中医研究,2018,31(8):22-23.
[46]傅杰,龚淑芳.甘麦大枣汤在甲亢病中运用体会[J].江西中医药,2011,42(4):31.
[47]曹琳.余江毅教授从肝论治甲状腺结节经验精萃[J].辽宁中医药大学学报,2010,12(10):124-125.
[48]姜德友,曲晓雪.瘿病的中医证治[J].河南中医,2016,36(7):1237-1239.