摘要
朝暮分调法是于清晨及傍晚采用不同方药分而调之的一种综合性治法,首见于薛己《内科摘要》。临床运用朝暮分调法治疗脾肾同病,多有效验,可弥补脾肾合方辨治思路存在的性味冗杂、药力掣肘等不足。刘喜明教授业医30余年,用药精简,善用经方,该文通过分析刘喜明教授辨治脾肾气虚证、脾肾阴虚证、脾肾阳虚证、脾肾阳衰证的验案4则,从气血阴阳的不同角度,尝试阐释朝暮分调脾肾法的基本内涵。该文指出脾肾虚损的各类顽疾均有运用朝暮分调法的契机,并总结刘师运用此法的临床指征主要包括症状随昼夜变化节律性加重或减轻的趋势、病势笃重迁延及病位上下阻隔等三大方面。归纳刘师运用朝暮分调各类细法的核心策略,在于重视昼夜消长节律、把握朝时阳升暮时阳降的病机变化特点,分调脾肾,使药力与天时相合。尝试为拓展因时制宜理论的运用范畴以及临床辨治脾肾虚损顽疾提供新思路。
Separated adjustment in the morning and evening is a kind of synthetical therapeutic method using different prescriptions in the morning and evening,which first appeared in XUE Ji′s Neike Zhaiyao.This method can effectively treat clinical spleen-kidney diseases.Professor LIU Ximing has been engaged in medicine for more than 30 years,with simplified medication and good use of classical prescriptions.By analyzing Professor LIU Ximing′s four cases of syndrome differentiation and treatment of Qi deficiency of spleen and kidney syndrome,Yin deficiency of spleen and kidney syndrome,Yang deficiency of spleen and kidney syndrome and Yang failure of spleen and kidney syndrome,this paper attempts to explain the basic connotation of the method of regulating spleen and kidney from Qi,blood,Yin and Yang.This paper points out that all kinds of persistent diseases with deficiency of spleen and kidney have the opportunity to use the method of regulating spleen and kidney in the morning and evening,and summarizes the clinical indications of LIU′s application of this method,mainly including the trend of aggravating or reducing the rhythmic change of symptoms with the day and night,the heavy migration of the disease and the obstruction of the upper and lower positions of the disease.It is concluded that the core strategy of LIU′s use of the method of regulating spleen and kidney in the morning and evening is to pay attention to the rhythm of diurnal growth and decline,grasp the characteristics of the pathogenesis of rising Yang in the morning and falling Yang in the evening,and adjust the spleen and kidney separately to make the drug power consistent with the time of day.This paper attempts to provide new ideas for expanding the application scope of the theory of adjusting measures to time and the clinical treatment of persistent diseases of spleen and kidney deficiency.
作者
付守强
汤阳
王程娜
朱晓云
刘喜明(指导)
FU Shouqiang;TANG Yang;WANG Chengna;ZHU Xiaoyun;LIU Ximing(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Bejing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《辽宁中医杂志》
CAS
2022年第5期37-39,共3页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金青年项目(81804085)
北京市科技计划研究项目(D08050703020803)
关键词
刘喜明
脾肾
验案
朝暮分调
LIU Ximing
spleen-kidney
clinical experience
separated adjustment in the morning and evening
