从肾气丸浅谈肾实证

摘要

自钱乙提出"肾主虚,无实"以来,肾无实证之说便为许多医家所推崇,然而在《黄帝内经》当中已经有了较为详细的关于肾实证脉象、症状表现和治法的记载.张仲景创立肾气丸治疗肾脏虚实夹杂之证,已经认识到了湿邪是导致肾实证的主要病因.结合当今时代特点,其病因又当以湿热和痰火为最多,在治疗上当遵循"实则泻之"的原则.%Since Qian Yi stated that kidney tends to be deficient rather than excessive, a general consensus about absence of kidney excess pattern has been reached among traditional Chinese practitioners in the ancient time.However, Huangdi's Internal Classic (Huangdi Neijing) has specifically recorded the pulses, symptoms, manifestations, and treatments of kidney excess pattern.Shenqi Wan (Kidney-qi pill) for complex pattern of deficiency and excess, which was created by Zhang Zhongjing, demonstrated morbid dampness was the main cause of kidney excess pattern.Dampness-heat and phlegm-heat is now considered as the dominant cause.In clinical practice, the principle of "treating an excess pattern by purgation" should be followed.