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中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (11): 1522-1527.doi: 10.19982/j.issn.1000-6621.20250329

• 论著 • 上一篇    下一篇

基于《理虚元鉴》“三本二统”治虚理论论治肺痨

穆婷婷, 张旭阳, 马艳(), 蔡秋杰()   

  1. 中国中医科学院中医临床基础医学研究所,北京 100700
  • 收稿日期:2025-08-11 出版日期:2025-11-10 发布日期:2025-10-30
  • 通信作者: 马艳,蔡秋杰 E-mail:mayan0825@sina.com;cqj@foxmail.com
  • 基金资助:
    国家重点研发计划(2023YFC3503402);中国中医科学院科技创新工程(CI2021A03703);国家中医药管理局项目(GZY-KJS-2017-016)

Treatment of pulmonary tuberculosis based on the theory of “three books and two systems” in the book Li Xu Yuan Jian

Mu Tingting, Zhang Xuyang, Ma Yan(), Cai Qiujie()   

  1. Institute of Clinical Basic Medicine of Traditional Chinese Medicine, Chinese Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2025-08-11 Online:2025-11-10 Published:2025-10-30
  • Contact: Ma Yan,Cai Qiujie E-mail:mayan0825@sina.com;cqj@foxmail.com
  • Supported by:
    National Key Research and Development Program(2023YFC3503402);Science and Technology Innovation Project of Chinese Academy of Traditional Chinese Medicine(CI2021A03703);National Administration of Traditional Chinese Medicine Project(GZY-KJS-2017-016)

摘要:

肺痨是中医虚劳病的重要分支,以正气亏虚为基础,痨虫侵袭为病因,涉及肺、脾、肾三脏功能失调。明代医家汪绮石在《理虚元鉴》中提出的“三本二统”治虚理论,为肺痨的辨证论治提供了指导。笔者结合古籍文献与现代临床实践,探讨“三本二统”理论对肺痨治疗的指导意义,明确了阴虚火旺为肺痨核心病机;肺脏失调为其起始环节,脾脏失调为其基础与转归,肾脏失调为其根源所在,三脏相互影响,共同构成肺痨的发病与传变过程;治疗以补肺脾肾为本,主要为滋阴降火以促金水相生、益气养阴以培土生金、滋阴补阳以固本培元,同时清火杀虫祛邪,兼顾止血化痰,扶正祛邪共调。同时结合运用“三本二统”理论治疗结核病验案,以期为中医药治疗肺痨提供理论依据与临床参考。

关键词: 医学,中国传统, 结核, 治疗应用

Abstract:

Pulmonary tuberculosis is an important branch of Traditional Chinese Medicine(TCM) deficiency and fatigue disease, caused by invasion of pulmonary tuberculosis insects and deficiency of vital energy, involving dysfunction of lungs, spleen, and kidneys. The “three books and two systems” theory proposed by Ming Dynasty physician Wang Qishi in his book Li Xu Yuan Jian provides guidance for the diagnosis and treatment of pulmonary tuberculosis based on syndrome differentiation. This article combines ancient literature and modern clinical practice to explore the guiding significance of the “three books and two systems” theory for pulmonary tuberculosis treatment, and clarifies that Yin deficiency and fire excess are the core pathogenesis of pulmonary tuberculosis; The imbalance of lungs is the starting point, the imbalance of spleen is the basis and outcome, and the imbalance of kidneys is the root cause. The three organs interact with each other and together constitute the pathogenesis and transmission process of pulmonary tuberculosis; Treatment should be based on nourishing lungs, spleen, and kidneys, mainly by nourishing Yin and lowering fire to promote the generation of gold and water, nourishing Qi and cultivating Yin to nourish soil and produce gold, nourishing Yin and supplementing Yang to strengthen the foundation and nourish the essence. At the same time, treatment should clear fire, kill insects, and eliminate evil, while also stop bleeding and resolving phlegm, and regulate the balance of supporting the body and eliminating evil, and combine with applying test cases of taking the “three books and two systems” theory on treating pulmonary tuberculosis, in order to provide theoretical basis and clinical reference for treating pulmonary tuberculosis with TCM.

Key words: Medicine, Chinese traditional, Tuberculosis, Therapeutic uses

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