| 赵燕,李良松.从张景岳郁证论治谈对丹溪学说的继承与发展[J].浙江中医药大学学报,2024,48(6):704-712. |
| 从张景岳郁证论治谈对丹溪学说的继承与发展 |
| Discussion on the Inheritance and Development of ZHU Danxi from Treatment on Depression Syndrome of ZHANG Jingyue |
| DOI：10.16466/j.issn1005-5509.2024.06.011 |
| 中文关键词: 郁证 张景岳 朱丹溪 理法方药 临证经验 浙派中医 |
| 英文关键词: depression syndrome ZHANG Jingyue ZHU Danxi principle-method-prescription-medicine system clinical experience Zhejiang school of TCM |
| 基金项目:国务院台湾事务办公室台湾中医药研究基地建设项目(国台七字〔2017〕170号) |
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| 中文摘要: |
| [目的] 探析明代浙江医家张景岳对朱丹溪治郁证经验的继承与发展。[方法] 采用文献研究和数据挖掘法，以《朱丹溪医学全书》《景岳全书》为蓝本，构建“郁证方药数据库”，探究用药规律，并研读整理郁证相关内容，从理法方药各角度归纳比较二者临证经验。[结果] 二者均认同气血结聚、升降失职的病机理论，然丹溪以脾胃为要，景岳以气机为关键。在临床辨证中，丹溪以病理因素为依据，将郁证分为气血湿食痰热六者；景岳吸收“六郁”理论，将郁证分为五气之郁和情志之郁。在用药上，丹溪从脾、肝、肺经入手，祛邪为要，理气为主，并辅以甘缓养阴；景岳用药，温补为主，又采丹溪之则，尤重滋阴，并以祛邪，故其用药攻补兼施，补益为主。[结论] 朱丹溪与张景岳均认同致郁关键为气血怫郁。丹溪分郁证为六郁，以祛邪为要；景岳分郁证为五气之郁、情志之郁二类，攻补兼施，尤重滋阴。景岳在继承丹溪理论之外，形成了独具特色的辨证论治体系。二者的郁证诊疗经验，可为当今郁证治疗提供范本。 |
| 英文摘要: |
| [OObbjjeeccttiivvee] To explore the inheritance and development of ZHANG Jingyue from ZHU Danxi，a Zhejiang traditional Chinese medicine doctor，in the Ming Dynasty on the diagnosis and treatment of depression syndrome. [MMeetthhooddss] By means of literature research and data mining，the“depression syndrome database”was constructed，ZHANG Jingyue and ZHU Danxi’s articles related to depression syndrome were screened and studied，and their academic thoughts were summarized and compared from the aspects of principle-methodrecip-medicines based on Jingyue Quanshu and ZHU Danxi Medical Book. [RReessuullttss] Both recognized the pathogenesis theory of Qi and blood accumulation and lifting，but ZHANG Jingyue attached importance to the role of human Qi movement，which was different from the view that Danxi attached importance to the spleen and stomach. In the syndrome differentiation，based on pathological factors，ZHU Danxi divided the depression syndrome into six types of Qi，blood and dampness，phlegm and heat. ZHANG Jingyue absorbed the theory of“six depressions”and divided it into the depression of five Qi and the depression of emotion. In terms of medication，Danxi started from the spleen，liver and lung meridian，removing evil as the main，coming Qi movement as the key，supplemented by sweet and soothing herbs and nourishing Yin. ZHANG Jingyue mainly used warm and supplementing herbs，and attached importance to nourishing Yin，and used the method of dispelling evil，so it could be summarized as reinforcement and elimination in combination，mainly reinforcement.[CCoonncclluussiioonn] Both ZHU Danxi and ZHANG Jingyue agreed that the key to the emergence of depression lied in the disharmony of Qi andblood. ZHU Danxi divided depression into“Six Depressions”，dispelling evil as the key; ZHANG Jingyue divided it into the depression of five Qi and the depression of emotion，reinforcing and eliminating in combination，especially nourishing Yin. On the basis of inheriting the theory of ZHU Danxi，ZHANG Jingyue formed a unique system of depression syndrome differentiation. The experience of the diagnosis andtreatment of depression syndrome can provide a model for the current treatment of depression syndrome. |
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