临证心得实录_临证指南医案心得

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《孙希圣临证心得实录》 内容提要

本书共分三章,第一章共80节,以医论医话的格式论述了内,外,儿,妇,五官科的部分病症,笔者的辨证论治心得体会,新认识,新见解。突出了整体观念和辨证论治的特色,既个体化治疗。每论都有中医传统方,笔者经验方,单验方,针灸急救方法,以及未病先防的预防医学和调护禁忌，显示了理法方药一条龙的学术观点。

第二章阐述古今对防衰延年,养颜美容的认识,有笔者的临证体会,可谓是当今人们尤其是妇女的必读之物。

第三章编录了笔者几十年记录的内外儿妇五官科治病验案,体现了中医学天人合一, 心身统一的整体统一观，人与社会、自然的天人相应论的辨证论治特点以及把人的生理、心理、环境综合在一起考虑一个人的健康状况来治疗解决多靶点，整体多层次，对多因素引起的的各科慢性疑难杂证,辨证论治的整体观念特色的经验运用反映。

目 录

第一章 医论医话篇.............................................................................................................001

一、论血瘀与活血化瘀...........................................................................................................001

二、谈治痰六法.........................................................................................................................003

三、习经要善悟 临证应承训..................................................................................................006

四、运用经络辨证的体会.......................................................................................................007

五、叶氏“上下交病，治在中焦”临床运用体会......................................................................................007

六、中医学矛盾病证之治法的体会........................................................................................009

七、时令病证的辩证论治心得................................................................................................011

八、谈治肺十六法...................................................................................................................026

九、慢性阻塞性肺病急性加重期证治体会...........................................................................030

十、哮喘证治刍议...................................................................................................................033

十一、咳嗽病证治心得...........................................................................................................035

十二、肝气虚肝阳虚之刍议...................................................................................................036

十三、治肝二十一法...............................................................................................................036

十四、慢性乙型肝炎证治心得......................................................................................................................................................................................043

十五、臌胀（肝 硬 变）的证治体会..........................................................039

十六、健脾利湿祛痰治脂肪肝................................................................................................045

十七、谈“乙癸同源，肝肾同治”........................................................................................046

十八、谈胸痹、心痛（冠心病，心绞痛）的辨证模式........................................................047

十九、谈心律失常中医证治新认识........................................................................................050

二十、脾胃学说的各科临床运用体会....................................................................................052 二

十一、《脾胃论》治则运用体会..........................................................................................054 二

十二、脾胃病证治三十九法..............................................................................................056

二

十三、话脾阴虚之鉴别、证治、用药体会........................................................................064

二十四、阴火论临床运用体会................................................................................................065 二

十五、胃痛证治二十法.......................................................................................................066 二

十六、胃病常见症状的辨证心法刍议....................................................................................069 二

十七、谈《金匮要略》保护胃气法....................................................................................071 二

十八、话朱丹溪的胃气论...................................................................................................072 二

十九、中医治疗慢性萎缩性胃炎的体会............................................................................073 三

十、萎缩性胃炎治疗用药的几点体会................................................................................076 三

十一、中医药治疗消化性溃疡病的体会............................................................................079 三

十二、治痞心得.....................................................................................................................082 三

十三、胆汁返流性胃炎小议................................................................................................085 三

十四、胃胆同病，胃胆同治小议........................................................................................086 三

十五、胆康治疗慢性胆道疾病的临床体会........................................................................087 三

十六、消息肉散治疗胆囊息肉体会....................................................................................087 三

十七、中医药治疗气虚型，阴虚型胆囊炎的体会............................................................088 三

十八、中药系列方溶排互补疗法治疗胆石症的体会........................................................089 三

十九、腹泻证治小议...........................................................................................................090 酸

十、溃疡性结肠炎证治体会................................................................................................092 四

十一、习惯性便秘证治心得................................................................................................093 四

十二、梅核气证治心得.......................................................................................................094 四

十三、奔豚气证治心得..........................................................................................................094 四

十四、各类慢性头痛证治体会...............................................................................................095 四

十五、眩晕小议.....................................................................................................................097 四

十六、老年脑病辨治体会......................................................................................................099 四

十七、消渴（糖尿病）刍议...................................................................................................101 四

十八、甲状腺机能亢进证治刍议............................................................................................102 四

十九、过敏性紫癜治疗体会...................................................................................................104 五

十、证治饮证临床新解..........................................................................................................104 五

十一、水肿证治分析..............................................................................................................106 五

十二、谈肾炎提高疗效，防止复发的几个问题................................................................109 五

十三、谈对六淋、尿血、尿浊、遗尿、失禁的证治新解........................................................110 五

十四、男子不育症的辩证论治体会........................................................................................115 五

十五、男子性功能衰弱小议(阳痿，遗精，早泄).................................................................117 五

十六、辨证论治活痹证............................................................................................................119 五

十七、神经紊乱性疾病的证治刍议.....................................................................................122 五

十八、脾胃学说在外科的临床应用.....................................................................................126 五

十九、水疝（鞘膜积液）证治体会........................................................................................127 六

十、狐疝（腹股沟疝）证治体会...........................................................................................128 六

十一、血栓性静脉炎证治体会.................................................................................................129 六

十二、附骨疽(骨髓炎)辩证论治体会..................................................................................130 六

十三、保守疗法治脱疽(脉管炎)证治体会.............................................................................132 六

十四、谈脾胃学说在妇科的临床应用.................................................................................134 六

十五、外敷药治疗妇科疾病的临床应用............................................................................136 六

十六、月经失调诸证证治小议.................................................................................................138 六

十七、痛经刍议......................................................................................................................144 六

十八、论虚论热论瘀治崩漏体会..........................................................................................145 六

十九、辨清阴阳气血痰瘀治闭经体会....................................................................................147 七

十、月经失调病应治月经期注意忌宜，自我调理....................................................................148 七

十一、治带下病需分白黄赤青黑............................................................................................149 七

十二、补肾疏肝化痰祛瘀治疗不孕症....................................................................................151 七

十三、小儿厌食症证治体会.................................................................................................152 七

十四、辨证论治治疗小儿慢惊风心得....................................................................................153 七

十五、滋补肝肾话五迟............................................................................................................154 七

十六、滋补肝肾益气补血话五软.............................................................................................155 七

十七、顽固性口疮证治心得.................................................................................................156 七

十八、鼻渊（鼻窦炎）证治体会.........................................................................................156 七

十九、慢性乳蛾（慢性扁桃体炎）的辨证论治........................................................................157 八

十、简廉效著的针、割、罐、挑疗法运用心得......................................................................158 第二章 抗衰美容篇.......................................................................................................159 第一节 抗衰益智...............................................................................................159

一、防治早衰，提高生命质量................................................................................................164

二、能防治早衰和抗衰老的中药............................................................................................164

三、防治早衰和延年益寿验方................................................................................................165

四、补脑益智验方...................................................................................................................165 第二节 防病养颜话美容.......................................................................................................165

一、毛发异常证治体会...........................................................................................................165

二、脱发证治体会...................................................................................................................166

三、雀斑证治体会.....................................................................................................................168

四、黄褐斑证治体会.................................................................................................................169

五、黎黑斑证治体会.................................................................................................................170

六、面游风（脂溢性皮炎）证治体会....................................................................................171

七、以肺风粉刺论治痤疮............................................................................................172

八、清肺化瘀辨治酒渣鼻...........................................................................................................174

十、面部毛细血管扩张症（俗称红脸蛋）经验方................................................................176

十一、美容验方.......................................................................................................................176 第三章

医案篇...................................................................................................................177

第一节 内科病.....................................................................................................................177

一、外感热病4例/急性菌痢1例..........................................................................................177

二、肺系病7例.......................................................................................................................179

三、肝病8例...........................................................................................................................182

四、胃病11例.........................................................................................................................186

五、泻泄10例.........................................................................................................................191

六、肠道梗阻5例...................................................................................................................194

七、结核性腹膜炎案1例.......................................................................................................195

八、脱肛案1例.......................................................................................................................195

九、胰胆病6例.......................................................................................................................196

十、阴火发热案3例...............................................................................................................198

十一、心脏病9例...................................................................................................................199

十二、血管病4例...................................................................................................................203

十三、血液病4例...................................................................................................................205

十四、肾病7例.......................................................................................................................207

十五、前列腺病4例...............................................................................................................210

十六、肾下垂1例...................................................................................................................211

十七、不育症案2例...............................................................................................................211

十八、糖尿病案2例...............................................................................................................212

十九、甲状腺2例...................................................................................................................213

二十、风湿关节病10例.........................................................................................................214 二

十二、头脑病7例...............................................................................................................218 二

十三、神经系病9例...........................................................................................................221 第二节 外科病.......................................................................................................................224

一、癌症4例...........................................................................................................................224

二、骨结核案1例...................................................................................................................226

三、骨髓炎2例.......................................................................................................................227

四、甲状腺瘤验案1例...........................................................................................................228

五、结节性红斑1例...............................................................................................................228

六、皮肤病2例.......................................................................................................................228

七、脱发案1例.......................................................................................................................229

八、口腔病5例.......................................................................................................................230

九、牙齿变黑腐烂案1例.......................................................................................................231

十、鼻病1例...........................................................................................................................231 第三节 妇科病.....................................................................................................................232

一、月经失调5例...................................................................................................................232

二、崩漏3例...........................................................................................................................234

三、闭经1例...........................................................................................................................235

四、滑胎病5例.......................................................................................................................235 五

不孕3例...........................................................................................................................238

六、不排卵型不孕症2例.......................................................................................................239

七、输卵管不通2例...............................................................................................................341

八、子宫发育不全典型病案.........................................................................................................九、乳腺增殖症案1例...........................................................................................................341

十、卵巢囊肿案1例...............................................................................................................341 附 录

服药必须忌口.....................................................................342