| 沈钦荣.张景岳五脏同补学说探析[J].浙江中医药大学学报,2020,44(11):1086-1089. |
| 张景岳五脏同补学说探析 |
| Explore ZHANG |
| DOI：10.16466/j.issn1005-5509.2020.11.012 |
| 中文关键词: 张景岳 五脏同补 五福饮 膝痹 医案 越医 浙派中医 温补学说 |
| 英文关键词: ZHANG Jingyue five viscera supplement theory Wufu drink knee arthralgia medical record Yue medicine Zhejiang School of Traditional Chinese Medicine warm tonification theory |
| 基金项目:浙江省名老中医专家传承工作室建设计划项目(GZS2017025)；浙江省中医药科研基金项目(2018ZA124) |
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| 中文摘要: |
| [目的]探讨张景岳五脏同补学说的渊源、意义及五脏同补代表方五福饮的现代研究进展。[方法]通过深入研究《内经》《类经》《景岳全书》，探讨张景岳五脏同补学说的渊源及意义，代表方五福饮的组成特色及适应范围；通过文献检索，了解五福饮现代临床及实验研究进展，并附个人临床医案阐释应用心得。[结果]张景岳五脏同补学说源于《内经》五行五藏的观点及相关论述，体现了其重阳不薄阴的温补核心思想、中年求复的治未病观和五脏互藏的整体观。通过临床实践及文献查新，认为五福饮适应范围广泛，对现代退行性骨关节病、肿瘤术后及亚健康调理尤为适宜。笔者拟定的五福健膝方(党参、熟地、当归、白术、甘草、牛膝、木瓜)以五脏同补、强筋壮膝为大法，在五福饮基础上选用强筋壮膝通络之牛膝、木瓜，切合膝骨关节炎五脏气血不足之主要病机。验案中患者系老年女性，中医诊断为膝痹病，辨证为五脏不足兼气血痹阻，治拟五脏同补、强筋壮膝为大法，佐祛风通络，以五福健膝方合鲍氏四神煎出入，获得良好疗效。[结论]五脏同补学说丰富了中医温补理论，对指导临床，尤其对治疗退行性骨关节病、肿瘤等疾病，以及治未病方面都有重要意义，进一步进行实验研究将有助于阐明其现代机制。 |
| 英文摘要: |
| [Objective] To explore the origin and significance of ZHANG Jingyue's five viscera supplement theory， and the modern research progress of Wufu drink， the representative prescription of this theory.[Methods] Through in-depth study of “The Yellow Emperor's Classic of Internal Medicine”“Classified Canon” and “Complete Works of Jingyue”， the origin and significance of ZHANG Jingyue's five viscera supplement theory were explored， the composition characteristics of Wufu drink and its indications which was the representative prescription of this theory were explained through literature retrieval， the progress of modern clinical and experimental research of Wufu drink was learned about， and the clinical experience was summarized and proved with a medical case.[Results]The theory of ZHANG Jingyue's five viscera supplement originated from the viewpoints and expositions of the five elements and five viscera in “The Yellow Emperor's Classic of Internal Medicine”， which embodied his core idea of warming and tonifying Yang without ignoring Yin， the concept of disease prevention needing to be restored in middle age， and the overall view of the internal inclusion of the internal organs. According to the clinical and literature studies， it is considered that Wufu drink has a wide range of adaptation and is particularly suitable for degenerative osteoarthropathy， tumor resection and sub-health care. Wufu Jianxi prescription is formulated by the author， Radix Codonopsis， Radix Rehmannia prepata， Radix Angelica sinensis， Rhizoma Atractylodes macrocephala， Radix Glycyrrhiza， Radix Achyranthes bidentatae and Fructus Chaenomelis are based on the principle of five viscera supplement theory and strengthen muscles and knees. On the basis of Wufu drink， Radix Achyranthes bidentatae and Fructus Chaenomelis are added to strengthen the bones and the knees， and dredge the meridians， which are consistent with the main pathogenesis of deficiency of Qi and blood in five viscera of knee osteoarthritis. The patient in the case was an elderly woman， who was diagnosed as knee arthralgia by traditional Chinese medicine(TCM) and the syndrome differentiation was deficiency of Qi and blood in five viscera combined with obstruction of Qi and blood. The main treatment principle was to supplement five viscera and tonifying the tendons and the knees， and dispel wind and dredg collaterals， after treated with Wufu Jianxi prescription combined with BAO's Sishen decoction， the patient achieved good curative effects. [Conclusion] Five viscera supplement theory has enriched the theory of warming and nourishing in TCM， and is of great significance in guiding the clinic， especially in the treatment of degenerative osteoarthropathy， tumors and prevention of diseases. Further experimental research will help to clarify its modern mechanism. |
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