| 殷丽茹,熊滔,魏托,等.新安“张一帖内科”痹病辨证思路探析[J].浙江中医药大学学报,2024,48(6):685-689. |
| 新安“张一帖内科”痹病辨证思路探析 |
| Analysis on Syndrome Differentiation of Arthralgia Disease in Xin’an“Zhangyitie Internal Medicine” |
| DOI：10.16466/j.issn1005-5509.2024.06.007 |
| 中文关键词: 新安医学 平调寒热 调和气血 “张一帖内科”痹病 扶元培土 化痰散瘀 |
| 英文关键词: Xin’an medicine “Zhangyitie Internal Medicine” arthralgia disease regulate cold and heat consolidating basis andcultivating primordial Qi harmonize Qi and blood resolve phlegm and disperse blood stasis |
| 基金项目:国家中医药管理局重点学科中医痹病学建设项目(国中医药人教发〔2012〕32号)；国家自然科学基金面上项目(81973828)；全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)；名中医工作室建设项目(皖卫中医药发〔2020〕1号)；安徽省中医药传承创新科研项目(2020ccyb03) |
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| 中文摘要: |
| [目的] 总结“张一帖内科”治疗痹病的中医辨证思路。[方法] 通过跟诊学习，收集、整理、分析典型医案，查阅相关中医古籍及文献，结合新安医学“张一帖内科”主要传承人国医大师李济仁及李艳教授临证时所谈所述，从痹病病因病机、创新痹病新安理论、临证论治三个方面总结“张一帖内科”治疗痹病的辨证思路与经验，并附医案两则加以佐证。[结果] 新安“张一帖内科”创新新安医学理论，创立“平衡寒热、扶元培土”学说，以“寒热三期”疗法治疗痹病，临证注重平调寒热、扶元培土、调和气血、化痰散瘀。验案一中患者反复多关节疼痛，病程长，李艳教授自创“益肾清络活血方”合乌头汤加裁“化痰散瘀”，治疗痰瘀互阻型痹病；验案二中患者劳累过度，湿邪入络，多关节疼痛、肿胀、活动不利，局部有热感，神疲乏力，李艳教授辨证该患者为痹病湿热内阻兼气血亏虚证，以“清热解毒、益气活血通络”平调寒热。[结论] 新安“张一帖内科”在治疗痹病实践中形成了自身独特的临床特色，辨证灵活，效果甚佳，是新安医学的重要分支，为中医药治疗痹病拓展了新思路，值得借鉴。 |
| 英文摘要: |
| [OObbjjeeccttiivvee] To summarize the traditional Chinese medicine(TCM) syndrome differentiation of“Zhangyitie Internal Medicine”to treat arthralgia disease. [MMeetthhooddss] By following patients and learning，collecting，sorting out and analyzing typical medical cases， consulting relevant ancient books and literature of TCM，comparing with what the main inheritors of“Zhangyitie Internal Medicine”， master of Chinese medicine LI Jiren and Professor LI Yan talked about in the clinical treatment of syndrome，summarizing the thought and experience of syndrome differentiation of“Zhangyitie Internal Medicine”in the treatment of arthralgia disease from three aspects: etiologyand pathogenesis，innovative new safety theory and clinical treatment，and adding two medical cases to prove it. [RReessuullttss] Xin’an“Zhangyitie Internal Medicine”innovated Xin’an medical theory，established the“balance of cold and heat，consolidating basis and cultivating primordial Qi”theory and“cold and heat three phases”therapy to treat arthralgia disease，focusing on regulating cold and heat in clinic，consolidating basis and cultivating primordial Qi，harmonizing Qi and blood，resolving phlegm and dispersing blood stasis. In case one，the patient with repeated joint pain，and a long course of the disease was diagnosed with phlegm-stasis mutual obstruction type arthralgia disease，Professor LI Yan used self-created“Yishen Qingluo Huoxui Formula”plus Wutou Decoction to resolve phlegm and disperse blood stasis. The patient was overworked in the second case with felt dampness，multi-joint pain，swelling，adverse activity， local heat sensation and spirit fatigue，Professor LI Yan differentiated the patient as internal obstruction of dampness-heat and deficiencyof Qi and blood type arthralgia disease and treated with clearing heat and detoxifying，invigorating Qi and activating blood to regulate cold and heat. [CCoonncclluussiioonn] Xin’an“Zhangyitie Internal medicine”has formed its unique clinical characteristics in the treatment of arthralgia disease practice，with flexible syndrome differentiation，very effective，is an important branch of Xin’an medicine，it expands new ideas for TCM treatment of arthralgia disease，worthy of reference. |
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