摘要
《金匮要略》中治疗情志病的方法有养阴清热法,主要运用于百合病及虚劳虚烦不得眠病证中;化痰解郁,顺气降逆法,主要用于梅核气的治疗;降逆平冲法,用于肝气不疏、气郁化火所致冲脉上逆和阳气受伤不固,冲气上逆而发奔豚;温中补虚,和里缓急法,适用于虚劳病脾胃阴阳两虚证;益气养血安神法,适用于心之气血亏虚证;温通心阳,镇静安神法,适用于心阳亏虚,神气浮越之证;养心安神,和中缓急法,适用于脏躁脏阴不足,心脾两虚证;温肾补虚法,适用于肾阳虚弱,温煦失职,膀胱气化不利,浊阴上扰所致心烦诸证;温肾补阳救逆法,适用于肾阳虚衰,阴盛格阳,虚阳浮越所致戴阳郁冒证;行气散结法,适用于气血郁滞,气机不畅而化热证;活血破瘀法,适用于瘀血闭阻较甚,瘀血内结上扰心神所致神志异常;清热活血,调和少阳法,适用于邪热传经入里与瘀血互结于血室,扰于心神而所致谵语;温经活血,养阴清热法,适用于冲任虚寒,瘀血内阻,阴虚内热所致咽干烦热证;清热祛湿法,适用于湿热之邪内蕴中焦,扰于心神所致各种情志异常;泻热通腑法,适用于实热结于胃肠之阳明腑实证;清热泻火法,适用于邪热之火上扰心神所致心烦懊恼不适之证,此虚烦非阴虚等虚证,而是指无形邪热未与有形之邪相结;祛痰化饮法,适用于痰饮之邪壅盛于内,闭阻气机,心神受扰所致烦躁不安、坐不得眠等症;安蛔杀虫止烦法,适用于因蛔上扰所致心烦之证,也可用于寒热错杂所致心烦不适。《金匮要略》对神志病的辨证准确详实,为后世情志病辨证治疗具有重要指导意义。其书中对情志病相关治疗的论述远不止上述所列,比如湿家诸烦的治疗,也比如针刺的治疗,也比如呕吐法的运用等,在情志异常相关疾病诊疗中需要因人而异,因病因病机不同而异,切忌千篇一律,离开辨证施治可能就会谬之千里。
There are many methods of treating emotional diseases in Essentials from the Golden Cabinet.They are as follows：Method of nourishing yin and clearing away heat is mainly used to treat lily disease,and insomnia due to consumption and restlessness.Method of resolving phlegm and removing stagnation,lowering the adverse flow of qi is mainly used to treat globus hystericus.Method of lowering qi and relieving coughis mainly used to treat running-pig sensation due to upward invasion qi of Chong Meridian and damaged yang qi resulting from stagnation of liver-qi transforming into fire.Method of warming middle-jiao and supplementing deficiency,regulating the interior and relieving spasm is mainly used to treat deficiency of both yin and yang of the spleen and stomach resulting from consumption disease.Method of supplementing qi and blood for tranquilization is mainly used to treat syndrome of deficient qi and blood in the heart.Method of warming heart yang for tranquilization is mainly used to treat syndrome of deficient heart yang and floating qi.Method of nourishing heart for tranquilization,regulating middle-jiao and relieving spasm is mainly used to treat syndrome of deficiency of the heart and spleen due to deficient hysteria and zang organs yin.Method of warming kidney and supplementing deficiency is mainly used to treat related syndromes of restlessness due to insufficient kidney yang leading to unsmooth qi activity of bladder,and turbid yin attacking upward.Method of warming kidney and supplementing yang for saving life is mainly used to treat syndromes of floating yang and oppressive feeling and dizziness due to deficient kidney yang,and yang kept externally by yin-excess in the interior,and floating deficient yang.Method of promoting qi circulation to remove stagnation is mainly used to treat syndrome of stagnated heat due to stagnated qi and blood and unsmooth qi activity.Method of promoting blood circulation to remove blood stasis is mainly used to treat severe blood stasis disturbing the heart leading to abnormality of emotions.Method of clearing away heat and promoting blood circulation,and harmonizing shaoyang is mainly used to treat delirium caused by disturbing the heart due to intermingled pathogenic heat and blood stasis in the blood chamber.Method of warming meridians and promoting blood circulation,nourishing yin and clearing away heat is mainly used to treat dry throat and restless heat due to yin deficiency bringing about interior heat resulting from deficiency and cold of Chong and Ren meridians and accumulated blood stasis.Method of nourishing yin and clearing away heat and removing dampness is mainly used to treat all kinds of abnormalities of emotions due to dampness and heat accumulating in middle-jiao and disturbing the heart.Method of purging heat and dredging fu-organs is mainly used to treat yangming fu-organ excess disease due to excessive heat accumulated in the stomach and intestines.Method of clearing away heat and purging fire is mainly used to treat restlessness and anger due to pathogenic fire attacking the heart.This kind of restlessness doesn＇t belong to yin deficiency syndrome,but is intermingled invisible and visible heat.Method of resolving phlegm and removing retention is mainly used to treat restlessness and insomnia due to excessive phlegm blocking qi activity and disturbing the heart.Method of removing ascariasis and stopping restlessness is mainly used to treat restlessness due to ascariasis,and restlessness due to concurrence of cold and heat syndromes.Essentials from the Golden Cabinet has important guiding significance of syndrome differentiation and treatment of emotional diseases for future generations due to its full and accurate syndrome differentiation.In fact,in terms of treating emotional diseases,there are more than the above methods,such as treating restlessness due to dampness syndrome,acupuncture therapy,vomiting therapy,etc.In the diagnosis and treatment of diseases related to abnormal emotions,it is necessary to consider different individuals,etiology and pathogenesis,following the same pattern should be forbidden,ignoring syndrome differentiation and treatment may have different efficacies.
作者
魏东生
邵卫
张忠文
刘兵舰
WEI Dong-sheng;SHAO Wei;ZHANG Zhong-wen;LIU Bing-jian(Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, Hubei, China ,430021)
出处
《河南中医》
2018年第4期495-498,共4页
Henan Traditional Chinese Medicine
关键词
情志病
《金匮要略》
养阴清热法
化痰解郁
顺气降逆法
降逆平冲法
补虚安神法
活血化瘀法
清热安神法
祛痰化饮法
安蛔杀虫止烦法
张仲景
emotional diseases
Essentials front the Golden Cabinet
method of nourishing yin and clearing away heat
method ofresolving phlegm and removing stagnation,method of lowering the adverse flow of qi
method of lowering qi and relieving cough
method of supplementing deficiency for tranquilization
method of promoting blood circulafion by removing blood stasis
method ofelearing away heat lot tranquilization
method of eliminating phlegm and removing retention
method of removing ascariasis andstopping restlessness：Zhang Zhong-jing
