摘要
清降法是中医学重要治法之一,叶天士善用清降之法诊治杂病,在《临证指南医案》中有丰富系统的临床实践体现.清降法以"清"与"降"为核心,二者相辅相成.清降法脏腑基础包括:六腑宜通,食滞化热;肺为华盖,其性肃降;肝胆火逆,乘土反金.叶氏结合疾病不同阶段灵活应用清降法,具体表现为:邪气无形,予桑叶、杏仁等轻清缓降;实邪渐成,予枳实、黄连等肃清通降;邪聚有形,予延胡索、川楝子等清降消通;邪去正伤,予芦根、麦冬等清补润降.本文结合《临证指南医案》中具体医案,分析叶氏对清降法的灵活应用.
The method of clearing and descending is one of the important therapeutic approaches in Traditional Chinese Medicine.Ye Tianshi was adept at using this method to treat miscellaneous diseases,and there are rich and systematic clinical practices reflected in Lin Zheng Zhi Nan Yi An(Case Records as a Guide to Clinical Practice).Clearing and descending complement each other.The visceral basis of this method:the six fu-organs should be free-flowing,with food stagnation transforming into heat;the lung serves as the canopy and has a depurative descending nature;liver-gallbladder fire counterflow invading earth and opposing metal.Ye's flexibly applied the method of clearing and descending according to different stages of the disease,specifically manifested as:for formless pathogenic factors,using Sangye(Folium Mori)and Xingren(Semen Armeniacae Amarum)for light clearing and gentle descent;for gradually formed substantial pathogens,using Zhishi(Fructus Aurantii Immaturus)and Huanglian(Rhizoma Coptidis)for purging and freeing descent;for aggregated form pathogens,using Yanhusuo(Rhizoma Corydalis)and Chuanlianzi(Fructus Toosendan)for clearing,descending,and dissipating obstruction;for post-pathogen removal with healthy qi damage,using Lugen(Rhizoma Phragmitis)and Maidong(Radix Ophiopogonis)for clearing supplementation and moistening descent.Specific case records from the book are analyzed to examine Ye's flexible application of the method of clearing and descending.
作者
王嘉祺
张希颜
陶婧娜
李彤
张丽菊
张忠绵
李志红
胡春宇
WANG Jiaqi;ZHANG Xiyan;TAO Jingna;LI Tong;ZHANG Liju;ZHANG Zhongmian;LI Zhihong;HU Chunyu(Department of Spleen and Stomach Diseases,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University;Graduate School,China Academy of Chinese Medical Sciences)
出处
《现代中医临床》
2025年第6期59-62,66,共5页
Modern Chinese Clinical Medicine
基金
国家自然科学基金项目(No.82074187)
北京市自然科学基金项目(No.7232290)
北京中医药大学东直门医院临床研究和成果转化能力提升试点项目(No.DZMG-MLZY-23009)
北京中医药薪火传承“新3+3”工程室站建设项目(No.2012-SZ-C-40)。
关键词
清降法
临证指南医案
叶天士
田德禄
method of clearing and descending
Lin Zheng Zhi Nan Yi An
Ye Tianshi
Tian Delu
