嶺南名醫甄夢初從瘀論治慢性肺系疾病經驗總結

張溪 張忠德 李際強 宋蘋

[摘要] 甄夢初是建國以來廣東省授予第一批名老中醫之一，他認為葉天士的“久病必瘀”“久病入絡”學說是慢性肺病病久必瘀的理論基礎，并在此基礎上提出“肺久必瘀，瘀祛證消”的觀點，詳細闡述“瘀血”在慢性肺系疾病中的中醫病機病理，方藥多以民間驗方鐵破湯加減，收效甚佳。現歸納、總結了甄夢初從瘀論治慢性肺系疾病的經驗，并附經典案例，為今后從“瘀血”論治慢性肺病提供一定的依據。

[關鍵詞] 嶺南;甄夢初;從瘀論治;鐵破湯;慢性肺病

[中圖分類號] R256.1? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）07（a）-0133-04

Summary on Lingnan famous doctor Zhen Mengchu′s clinical experience on chronic pulmonary diseases treatment based on the theory of stasis

ZHANG Xi1? ?ZHANG Zhongde2? ?LI Jiqiang1? ?SONG Ping2

1.The Third Comprehensive Department， University Town Hospital， Guangdong Hospital of Traditional Chinese Medicine， Guangdong Province， Guangzhou? ?510006， China; 2.Medical Education Office， Guangdong Hospital of Traditional Chinese Medicine， Guangdong Province， Guangzhou? ?510000， China

[Abstract] Zhen Mengchu was one of the first batch of prestigious Chinese physicians in Guangdong Province since the founding of the People′s Republic of China. He believed that the theory of “chronic diseases causing stasis” and “chronic diseases transforming to collaterals” of Ye Tianshi is the theoretical basis of chronic lung disease causing stasis， on the basis of which， he put forward the viewpoint of “chronic lung diseases causing stasis， removing stasis for eliminating syndrome”， elaborated the TCM pathology and pathogenesis of “blood stasis” in chronic pulmonary diseases， he usually used Tiepo Decoction of folk prescription and has achieved good effects. This paper summarizes the experience of Zhen Mengchu in the treatment of chronic lung disease from the theory of stasis， with a classic case， which provides a certain basis for the treatment of chronic lung disease from “blood stasis”.

[Key words] Lingnan; Zhen Mengchu; Treatment based on the theory of stasis; Tiepo Decoction; Chronic pulmonary diseases

甄夢初（1909～1990），出生于中醫藥世家，是建國以來廣東省政府授予的第一批名老中醫之一，德馨粵南北，譽享省港澳。甄夢初先生從醫六十余載，熟讀葉天士、吳瑭、王孟英等中醫醫家的醫籍，其后期所形成的中醫理論則以《黃帝內經》《傷寒論》《金匱要略》等學術思想為根基，結合自己的臨床實踐和研究，臨證取方以葉天士《臨證指南醫案》為基礎，同時受金元四大家的影響，尤以朱丹溪的學術思想為主，逐漸在嶺南常見病、多發病的防治上形成了自己獨特的中醫思維形式，成為嶺南地區甄氏雜病流派的開世之祖[1]。作為甄氏流派第五代傳承人，筆者在研讀甄夢初先生的手稿過程中，整理出一些甄夢初先生從“瘀血”方面論治慢性肺系疾病的經驗，現分享如下：

1 從“瘀”論治的淵源

肺結核，中醫又稱“肺癆”，其病程纏綿，病情復雜，耐藥率高，久治難愈，是中醫“風、癆、鼓、膈”四大疑難頑癥之一。……