文章摘要
吴素素,黄巧艺,李浩.《伤寒杂病论》心悸证治特色探赜[J].浙江中医药大学学报,2023,47(11):1354-1358.
《伤寒杂病论》心悸证治特色探赜
Exploration of the Syndrome and Therapeutic Characteristics of Palpitations Based on Treatise on Febrile and Miscellaneous Diseases
DOI:10.16466/j.issn1005-5509.2023.11.020
中文关键词: 伤寒杂病论  心悸  证型分类  方药特色  温阳化饮  杂合以治  形神同调  特殊煎服法
英文关键词: Treatise on Febrile and Miscellaneous Diseases  palpitation  syndrome types  medication characteristics  warming Yang for resolving fluid retention  comprehensive treatment  simultaneous regulation of body and spirit  special decoction methods
基金项目:中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者项目(国中医药办人教函〔2019〕62号);中央级公益性科研院所基本科研业务费专项资金资助项目(ZZ15-XY-PT-02)
作者单位
吴素素 北京中医药大学 北京 100029
中国中医科学院望京医院 
黄巧艺 北京中医药大学 北京 100029
中国中医科学院西苑医院 
李浩 中国中医科学院望京医院
中国中医科学院西苑医院 
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中文摘要:
      [目的] 探析《伤寒杂病论》中仲景对心悸的治疗特色。[方法] 通过对《伤寒杂病论》中心悸条文的系统研读,结合对其他古籍论述的学习,归纳总结《伤寒杂病论》中心悸证型分类,并剖析仲景治疗心悸的遣方用药特点。[结果] 在八纲辨证理论基础上,可将心悸条文总结归纳为心阳亏虚、水饮内停、气血虚弱、气机不利、阴虚火旺五类证型,仲景治疗时常以温阳为重、化饮为先,温阳以桂枝配伍甘草为核心药对,化饮则茯苓为最佳选择;体现了合法而施、多法并用、三因制宜的杂合以治的学术特点;遵循形神同调,双心并治的治疗思想;根据患者证型特点,选取不同的特殊煎服法,重视煎服法的运用。[结论] 临证治疗心悸时要明辨证型分类,借鉴学习仲景温阳化饮、杂合以治、形神同调、选取不同煎服法的证治特色,有助于进一步拓宽临床诊疗思路,对于临证治疗心悸有重要的启迪作用。
英文摘要:
      [Objective] To explore the therapeutic characteristics of ZHANG Zhongjing on palpitations in Treatise on Febrile and Miscellaneous Diseases. [Methods] Treatise on Febrile and Miscellaneous Diseases has a comprehensive discussion on palpitations. Through the systematic study of the provisions of palpitation in Treatise on Febrile and Miscellaneous Diseases and combined with the study of other ancient books, the author summarized the classification of palpitation in Treatise on Febrile and Miscellaneous Diseases, and analyzed the characteristics of ZHANG Zhongjing. [Results] On the basis of the eight principles of syndrome differentiation, the provisions of palpitation can be summarized as five categories: deficiency of heart Yang, internal retention of retained fluid, weakness of Qi and blood, disorder of Qi movement, and fire excess from Yin deficiency. To analyse the medication characteristics of ZHANG Zhongjing’s palpitation prescription, it was found that ZHANG Zhongjing’s treatment often focused on warming Yang and regulating retained fluid first. For warming Yang, Ramulus Cinnamomi combined with Glycyrrhiza uralensis Fisch. was the core drug pair, while Poria cocos was the best choice of regulating retained fluid, which reflected the academic characteristics of the combination of treatments application, multiple methods and three factors. Treatment idea followed the treatment of double hearts, simultaneous regulation of body and spirit. According to the characteristics of the patient’s syndrome, different special decoction methods were selected, and the application of decoction methods was emphasized. [Conclusion] In the temporary treatment of palpitation, it should be differentiated and learnt from the characteristics of warming Yang for resolving fluid retention, comprehensive treatment, simultaneous regulation of body and spirit and selection of different decoction methods, which can further broaden the clinical diagnosis and treatment ideas and has a great enlightening effect on the temporary treatment of palpitation.
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