《金匮要略》从脏腑论治神志病学术思想探析

中医认为,五脏藏神,情志活动亦为五脏所主,五脏功能不调,神明被扰,可引发情志病。《金匮要略》从脏腑论治情志病,以调整五脏阴阳为切入点,尤其重视调阴阳、立中气,通过调和五脏阴阳以镇心安神、宁心安神。《金匮要略》记载的情志病的证治主要有:从心肺阴虚内热论治百合病,方选百合地黄汤以养心肺之阴治本,兼清虚热治标;从心肝血虚、虚火内扰心神论治不眠,方选酸枣仁汤以补肝体、养肝血、清虚热、养心安神;从心肾不交、阴阳俱虚论治梦交,方选桂枝加龙骨牡蛎汤以交通心肾、潜镇摄纳、调畅阴阳;从心脾气血不足论治脏躁,方选甘麦大枣汤以调补气血、养心安神;从肝胆气血虚弱、邪热入里论治谵语,方选小柴胡汤解郁达邪以复少阳之机。

Discussion on Academic Thought of Treating Emotional Disease from Zang and Fu in Jin Gui Yao Lue

Chinese medicine believes that the Five Zang governs human emotion and spirit,or the emotional activities are governed by the Five Zang. When the functions of the Five Zang are abnormal,emotion and spirit would be disturbed,which can cause emotional illness eventually. In Jin Gui Yao Lue emotional illnesses are treated from the Yin and Yang of the Five Zang as well as strengthen the Zhong Qi,so as to each one’s mind. The symptoms and treatments of emotional illnesses recorded in Jin Gui Yao Lue mainly include the followings: the treatment of Baihe disease from the internal Heat of Heart and Lung Yin deficiency with Baihe Dihuang Decoction;the treatment of insomnia due to the disturbance of deficiency Fire induced by Heart and Liver Blood deficiency with Suanzaoren Decoction;the treatment of sexual intercourse in dream from Heart and Kidney disharmony due to deficiency of Heat and Kidney with Guizhi being added in Longgu Muli Decoction;the treatment of Zang Zao from Heart and Spleen Qi deficiency with Ganmai Dazao Decoction;the treatment of delirium from Liver and Gallbladder Qi and Blood Deficiency with Xiao Chahu Decoction. ty chose Xiao Chaihu Tang to solve Yu Daxie’s opportunity to recover Shaoyang.