| 伍竹君,王邦才,包科颖,等.王邦才教授对“上下交损当治其中”理论的发微与临床应用[J].浙江中医药大学学报,2020,44(5):447-450, 454. |
| 王邦才教授对“上下交损当治其中”理论的发微与临床应用 |
| Professor WANG Bangcai's Academic Explanation of the Theory on “Treatment of Simultaneous Upper and Lower Diseases Focusing on Spleen and Stomach” and Clinical Application |
| DOI：10.16466/j.issn1005-5509.2020.05.009 |
| 中文关键词: 上下交损当治其中 中焦 理论发微 临床应用 王邦才 名医经验 |
| 英文关键词: treatment of simultaneous upper and lower diseases focusing on spleen and stomach middle Jiao academic explanation of the theory clinical application WANG Bangcai famous doctor's experience |
| 基金项目:浙江省中医药管理局名老中医专家传承工作室建设项目(GZS2017018) |
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| 中文摘要: |
| [目的]探讨王邦才教授对叶天士重要理论“上下交损当治其中”的发微及临床应用。[方法]通过采集与分析王邦才教授采用“上下交损当治其中”理论治疗的临床病例，结合历代名医相关论述，进一步分析王教授对该理论的阐述和补充，以及运用该理论治疗病机复杂的疑难杂症的用药特色，并列举验案加以佐证。[结果]王邦才教授应用“上下交损当治其中”理论娴熟，结合中焦病理生理特性，兼顾上焦下焦整体的关系，治中焦而得全局，使脾胃运化正常、气机调达。确立治则和方药时注意纳运合宜，着力升降润燥；三因制宜，兼顾环境影响，用药注重寒热同调、燥湿相济、升降相用、补泄兼施、身心同治。对中风重症脾胃失健，气血两虚上下交病者，治以健脾益气、养血和营，方用归芍异功散合黄芪桂枝五物汤；对积聚脾肾两虚、湿热蕴结病机疑难者，予固护脾胃、扶正祛邪，方用附子米仁败酱汤合香砂六君汤加减，总以脾胃为枢、中洲为要，均获得较好的临床疗效。[结论]王邦才教授对“上下交损当治其中”理论的发微，强调了“治中焦”的意义，其经验值得临床推广学习。 |
| 英文摘要: |
| [Objective]To discuss the academic explanation and clinical application of Professor WANG Bangcai on the important theory of “treatment of simultaneous upper and lower diseases focusing on spleen and stomach” which was provided by YE Tianshi. [Methods]Through collecting and analyzing the clinical cases of Professor WANG using theory of “treatment of simultaneous upper and lower diseases focusing on spleen and stomach”， combined with the relevant discussions of famous doctors in previous dynasties， Professor WANG's elaboration and supplement of this theory， and the clinical practices in which he applied this theory in treating complicated diseases with difficult pathogenesis were furtherly analyzed， and two cases were presented as proof.[Results] Professor WANG is good at applying this theory to treat difficult and miscellaneous diseases of internal medicine， at the same time he makes a further explanation and elucidating of this theory.In the clinical treatment， Professor WANG takes into account the relationship between the upper and lower Jiao as a whole， combined with the pathophysiological characteristics of middle Jiao， treats middle Jiao and acquires the overall situation， so that transporting and transforming function of the spleen and stomach can be recuperated normally and the Qi mechanism can be adjusted.When establishing the treatment principles and prescriptions， Professor WANG pays more attention to the proper delivery and transportation， focusing on the ascending and descending， moistening dryness; and takes three categories of etiologic factors into account， including environmental impact. Professor WANG often chooses herbs considering cold and heat， dry and dampness， ascending and descending， tonification and purgation， and treatment of body and mind simultaneously.For the patient who suffered from severe spleen and stomach deficiency due to stroke， Qi and blood deficiency and upper and lower intersection disease， he treated the patient by strengthening the spleen and invigorating Qi， nourishing blood and harmonizing Yingfen with Guishao Yigong powder and Huangqi Guizhi Wuwu decoction. For the patient of spleen and kidney deficiency due to abdominal mass， the pathogenesis of dampness and heat accumulation was complicated， Professor WANG treated by strengthening the spleen and stomach， strengthening the body resistance to eliminate pathogenic factors with Fuzi Miren Baijian decoction and Xiangsha Liujunzi decoction.In such situation，both patients achieved good clinical effects with spleen and stomach as the key factor of treatment， and paid more attention to regulate the function of the spleen and stomach. [Conclusion]Professor WANG elucidates the theory of “treatment of simultaneous upper and lower diseases focusing on spleen and stomach”， emphasizing the significance of the “treating focus on spleen and stomach”， and his experience is worthy of clinical promotion and learning. |
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