疮痈篇之预设动画课件

金匮某些理论的临床运用金匮某些理论的临床运用 主讲主讲 伍伍 炳炳 彩彩 一、痒为风邪外泄一、痒为风邪外泄 不可盲目止痒不可盲目止痒 金匮水气病脉证并治第十四 脉浮而洪，浮则为风，洪则为气，风气相搏 ，风强则为隐疹，身体为痒，痒为泄风，久 为痂癞；气强则为水，难以俯仰。风气相击 ，身体洪肿，汗出乃愈。恶风则虚，此为风 水；不恶风者，小便通利，上焦有寒，其口 多涎，此为黄汗。（2） 一、痒为风邪外泄一、痒为风邪外泄 不可盲目止痒不可盲目止痒 痒为泄风，不可盲目止痒 用中药外敷又如何呢？ 外用止痒药对身体虚者要慎重 某些慢性病经治疗后好转，重新出现脚气 为好事 二、补心气以安心神二、补心气以安心神 分虚实以宁神志分虚实以宁神志 金匮五脏风寒积聚病脉证并治第十一 邪哭使魂魄不安者，血气少也；血气少者属 于心，心气虚者，其人则畏，合目欲眠，梦 远行而精神离散，魂魄妄行。阴气衰者为癫 ，阳气衰者为狂。（12） 胆小有血虚、气虚之别 神志疾患用中药疗效好 二、补心气以安心神二、补心气以安心神 分虚实以宁神志分虚实以宁神志 三、失精是青少年不可忽视的致病因素三、失精是青少年不可忽视的致病因素 金匮血痹虚劳病脉证并治第六 夫失精家少腹弦急，阴头寒，目眩，发 落，脉极虚芤迟，为清谷亡血，失精。 脉得诸芤动微紧，男子失精，女子梦交 ，桂枝加龙骨牡蛎汤主之。（8） 失精表现 临床意义 治疗注意点 三、失精是青少年不可忽视的致病因素三、失精是青少年不可忽视的致病因素 四、脉象可判断预后吉凶四、脉象可判断预后吉凶 金匮血痹虚劳病脉证并治第六 夫男子平人，脉大为劳，极虚亦为劳。（3 ） 金匮痰饮咳嗽病脉证并治第十二 久咳数岁，其脉弱者可治；实大数者死；其 虚者必苦冒。其人本有支饮在胸中故也，治 属饮家。（34） 五、胃气上逆不可一味降逆和胃五、胃气上逆不可一味降逆和胃 金匮消渴小便利淋病脉证并治第十三 渴欲饮水，水入则吐者，名曰水逆，五苓散渴欲饮水，水入则吐者，名曰水逆，五苓散 主之。主之。 （5） 太阳为寒水之经，寒为水之气，同气相求很太阳为寒水之经，寒为水之气，同气相求很 容易引动水饮。容易引动水饮。五苓散案五苓散案 五、胃气上逆不可一味降逆和胃五、胃气上逆不可一味降逆和胃 金匮呕吐哕下利病脉证治第十七 哕而腹满，视其前后，知何部不利，利之即哕而腹满，视其前后，知何部不利，利之即 愈。愈。（7） 温胆汤合小陷胸汤案温胆汤合小陷胸汤案 五、胃气上逆不可一味降逆和胃五、胃气上逆不可一味降逆和胃 金匮消渴小便利淋病脉证并治第十三 厥阴之为病，消渴，气上冲心，心中疼热，厥阴之为病，消渴，气上冲心，心中疼热， 饥而不欲食，食即吐，下之不肯止。饥而不欲食，食即吐，下之不肯止。（1） 乌梅丸案乌梅丸案 肝病可治脾，脾病亦可治肝肝病可治脾，脾病亦可治肝 脾胃病的区别脾胃病的区别 六、失眠不可只用归脾汤、补心丹六、失眠不可只用归脾汤、补心丹 金匮消渴小便利淋病脉证并治第十三 脉浮发热，渴欲饮水，小便不利者，猪苓汤脉浮发热，渴欲饮水，小便不利者，猪苓汤 主之。主之。（13）猪苓汤案猪苓汤案 失眠治法失眠治法 七、熄肝风清肝热也可治肾结石七、熄肝风清肝热也可治肾结石 金匮呕吐哕下利病脉证治第十七 热利下重者，白头翁汤主之。热利下重者，白头翁汤主之。（43）白白 头翁汤合导赤散案头翁汤合导赤散案 鉴别鉴别 八、心动过缓从湿论治八、心动过缓从湿论治 金匮黄疸病脉证并治第十五 寸口脉浮而缓，浮则为风，缓则为痹，痹非中风寸口脉浮而缓，浮则为风，缓则为痹，痹非中风 ，四肢苦烦，脾色必黄，瘀热以行。，四肢苦烦，脾色必黄，瘀热以行。（1 1） 金匮痉湿暍病脉证治第二 金匮水气病脉证并治第十四 风湿（水），脉浮身重，汗出恶风者，防己黄芪风湿（水），脉浮身重，汗出恶风者，防己黄芪 汤主之。汤主之。（22）防己黄芪汤案防己黄芪汤案 临床应用临床应用 九、疑难发热九、疑难发热 金匮痉湿暍病脉证治第二 病者一身尽疼，发热，日晡所剧者，名风湿。此病者一身尽疼，发热，日晡所剧者，名风湿。此 病伤于汗出当风，或久伤取冷所致也。可与麻黄病伤于汗出当风，或久伤取冷所致也。可与麻黄 杏仁薏苡甘草汤。杏仁薏苡甘草汤。（21） 金匮脏腑经络先后病脉证第一 师曰：病人语声寂然喜惊呼者，骨节间病；语声师曰：病人语声寂然喜惊呼者，骨节间病；语声 喑喑然不彻者，心膈间病；语声啾啾然细而长者喑喑然不彻者，心膈间病；语声啾啾然细而长者 ，头中病，头中病。（4）麻杏苡甘汤案麻杏苡甘汤案 九、疑难发热九、疑难发热 金匮中风历节病脉证并治第五 寸口脉沉而弱，沉即主骨，弱即主筋，沉即寸口脉沉而弱，沉即主骨，弱即主筋，沉即 为肾，弱即为肝。汗出入水中，如水伤心，为肾，弱即为肝。汗出入水中，如水伤心， 历节黄汗出，故曰历节。历节黄汗出，故曰历节。 （4）长期发长期发 热案热案 九、疑难发热九、疑难发热 金匮呕吐哕下利病脉证治第十七 呕而发热者，小柴胡汤主之。呕而发热者，小柴胡汤主之。（15）小小 柴胡汤案柴胡汤案 九、疑难发热九、疑难发热 金匮妇人产后病脉证治第二十一 产后风续之数十日不解，头微痛，恶寒，时产后风续之数十日不解，头微痛，恶寒，时 时有热，心下闷，干呕，汗出，虽久，阳旦时有热，心下闷，干呕，汗出，虽久，阳旦 证续在耳，可与阳旦汤。证续在耳，可与阳旦汤。（8）桂枝汤桂枝汤 案案 十、鱼鳞病活血化瘀有效十、鱼鳞病活血化瘀有效 金匮血痹虚劳病脉证并治第六 五劳虚极羸瘦，腹满不能饮食，食伤、忧伤五劳虚极羸瘦，腹满不能饮食，食伤、忧伤 、饮伤、房室伤、饥伤、劳伤、经络营卫气、饮伤、房室伤、饥伤、劳伤、经络营卫气 伤，内有干血，肌肤甲错，两目黯黑。缓中伤，内有干血，肌肤甲错，两目黯黑。缓中 补虚，大黄补虚，大黄 虫丸主之。虫丸主之。（18）大黄大黄 虫丸案虫丸案 十一、剂型不同，疗效有别十一、剂型不同，疗效有别 丸者缓也丸者缓也 B3E6H9LcOgRjUmYp!s&w)z1C4F7JaMdPhSkWnZq$u*x-A2D5H8KbNfQiTlXo#s%v(y0B3E6I9LcOgRjVmYp!t&w)z1C4G7JaMePhSkWnZr$u*x+A2D5H8KcNfQiUlXo#s%v)y0B3F6I9LdOgSjVmYq!t&w-z1D4G7JbMePhTkWnZr$u(x+A2E5H8KcNfRiUlXp#s%v)y0C3F6IaLdOgSjVnYq!t*w-z1D4G8JbMeQhTkWoZr%u(x+B2E5H9KcOfRiUmXp#s&v)z0C3F7IaLdPgSjVnYq$t*w-A1D4G8JbNeQhTlWoZr%u(y+B2E6H9KcOfRjUmXp!s&v)z0C4F7IaMdPgSkVnZq$t*x-A1D5G8KbNeQiTlWo#r%u(y+B3E6H9LcOfRjUmYp!s&w)z0C4F7JaMdPhSkVnZq$u*x- 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