文章摘要
蔡嘉缘,徐若瑶,高祥福.“治风先治血”理论探讨与治血三层次[J].浙江中医药大学学报,2022,(5):535-538.
“治风先治血”理论探讨与治血三层次
Discussion on the Theory of“To Treat the Wind, Treating the Blood First” and Three Levels of Treating Blood
DOI:10.16466/j.issn1005-5509.2022.05.013
中文关键词: 治则  内风  外风  偏枯  血虚  精血亏虚  治疗层次
英文关键词: therapeutic principle  external wind  internal wind  hemiplegia  blood deficiency  deficiency of essence and blood  treatment level
基金项目:浙江省名老中医专家传承工作室建设项目(GZS2020027)
作者单位
蔡嘉缘 浙江中医药大学第一临床医学院 杭州 310053 
徐若瑶 浙江中医药大学第三临床医学院 
高祥福 浙江中医药大学附属第一医院 
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中文摘要:
      [目的] 对治则“治风先治血,血行风自灭”进行内涵梳理及阐发,总结临床运用之法。[方法] 收集并梳理风和血的关系,以及前人对此治则的理解及应用,通过分析探讨内涵外延,归纳总结风证的核心病机,得出相应的治血之法,并列举验案一则作为佐证。[结果] 诸代医家认为,津血亏虚会导致外风内侵和内风丛生,在治疗中对血的病机认识主要是血虚、血瘀和血热。笔者首分虚实,指出风证的病机主要分为邪风和阴血阴液不足,强调阴液不足的三个层次,分别为相对津血不足、绝对血虚、绝对精血亏虚;并提出治血三层次:治标兼以益津血、养血兼以健脾胃、填精补肝肾。所举医案中患者痛风发作,伴皮肤皲裂,为湿热熏蒸,耗伤津血,治以清利湿热、益津润燥。[结论] 临床认识风证可从邪风和阴血阴液两方面病机进行考量,并根据阴液不足的程度,合理运用“治血三层次”进行治疗,该思路对指导临床有实用价值,值得同道借鉴。
英文摘要:
      [Objective] To sort out and extend the connotation of the principle“to treat the wind, treating the blood first; the blood flows smoothly and the wind begins to disperse”, and summarize the methods of clinical application. [Methods] The relationship between wind and blood was collected and analyzed, as well as previous understandings and applications of this treatment principle. Through analysis and discussion and connotation extension, the core pathogenesis of wind syndrome was summarized, and corresponding treatment methods for blood were obtained. And a case was listed as evidence. [Results] Various generations of doctors believe that blood deficiency will lead to external wind invasion and internal wind clumping; blood deficiency, blood stasis and blood heat are the main pathogenesis of blood in treatment. The author points out that the pathogenesis of wind syndrome is mainly divided into evil wind and deficiency of blood and Yin, emphasizes three levels of deficiency, namely relative deficiency of blood, absolute deficiency of blood and absolute deficiency of essence and blood, and puts forward three levels of treatment: Treating symptoms and enriching blood, nourishing blood and strengthening the spleen and stomach, and filling essence and supplementing the liver and kidney. In the case mentioned, the patient suffered from gout attack accompanied by chapped skin, and was treated with damp-heat fumigation, which consumed blood and Yin. [Conclusion] The clinical understanding of wind syndrome can be considered from two aspects: Evil wind and blood and Yin, and according to the degree of Yin deficiency, reasonable use of “three levels of treating blood” for treatment. This idea has practical value for clinical guidance, and is worthy of fellows reference.
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