张杰运用“肝脾建中”思想临床治验浅析

目的]浅析张杰教授运用"肝脾建中"思想辨治疾病的经验。方法]通过跟随张杰教授门诊,选取张师运用"肝脾建中"思想辨治的肝积、呕吐、痫病、痿证之验案4则,并结合历代名家的相关论述,从病因病机、治则治法、用药特点等方面对验案进行分析,进一步研讨"肝脾建中"思想。结果]张师认为,肝脾在生理上同居中焦,关系密切,为后天之源泉,人身之枢机,病理上则每易相兼为病,独创"肝脾建中"思想指导临床。"肝脾建中"思想是将肝脾作为一个矛盾的整体纳入杂病的辨治过程,其指导下的治法即是肝脾同治、调和气血、健运中焦,以协调上下,通达内外,临证用于辨治肝郁脾虚、痰毒瘀阻之肝积,肝气犯胃、胃阴不足之呕吐,肝脾两虚、风痰上扰之痫病,阳气不足、络脉瘀阻之痿证等,疗效显著。结论]张师临证运用"肝脾建中"思想辨治疾病,旨在突显肝脾二脏的相关性及"肝脾建中"的重要性,经验特色鲜明,值得学习和推广。

ZHANG Jie’s Application of the Thoughts of “Liver and Spleen Construction for the Middle-Jiao ”

Objective] To analyze Professor ZHANG Jie’s experience of syndrome differentiation and treatment of diseases with the thoughts of "liver and spleen construction for the middle-Jiao ".Methods] Through following Professor ZHANG Jie’s outpatient work, four cases of liver accunulation, vomiting,epilepsy and impotence syndrome were selected which were syndrome differentiated and treated according to the thoughts of "liver and spleen construction for the middle-Jiao", and the cases were analyzed from the aspects of etiology, pathogenesis, treatment principles, treatment methods and drug characteristics in combination with the relevant discussions of famous experts in previous dynasties,so as to have a further study of the thoughts of "liver and spleen construction for the middle-Jiao ". Results] According to Professor ZHANG, liver and spleen live together in middle-Jiao physiologically and are closely related. They are the source of postnatal development, the axis of human body, and they are often accompanied in disease pathologically.Professor ZHANG creates the thoughts of "liver and spleen construction for the middle-Jiao" to guide clinical practice. The thoughts of "liver and spleen construction for the middle-Jiao" takes the liver and spleen as a whole of contradiction into the syndrome differentiation and treatment process of miscellaneous diseases. The treatment methods under its guidance are to treat the liver and spleen together, harmonize Qi and blood, strengthen the middleJiao, coordinate the upper and lower, and access to the internal and external, and the methods are often adopted for syndrome differentiation and treatment of liver accumulation of liver stagnation and spleen deficiency, phlegm toxin and blood stasis;vomiting of liver Qi invading stomach and deficiency of stomach Yin;epilepsy of deficiency of the liver and spleen, wind and phlegm harassing the upper body;impotence syndrome of deficiency of Yang Qi and blood stasis of collaterals, and the curative effect is significant. Conclusion] Professor ZHANG’s uses the thoughts of "liver and spleen construction for the middle-Jiao" in clinic to distinguish and treat diseases, aiming to highlight the correlation between the two organs of liver and spleen and the importance of the thoughts of "liver and spleen construction for the middle-Jiao". The experience is distinctive, which is worth learning and promoting.