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1、中医内科学总结第一单元肺系病证一、感冒基本病机:外邪袭表,肺卫失与。病位:主要在肺卫。实证:1-4 1、风寒证-辛温解表,宣肺散寒-荆防败毒散若湿较重,肢体酸痛,头重头胀,身热不扬,-羌活胜湿汤2、风热证-辛凉解表,宣肺清热-银翘散3、暑湿证-清暑祛湿解表-新加香薷饮小便短赤加六一散、赤苓4、秋燥证-润燥疏表-温燥-桑杏汤加减,凉燥-杏苏散加减。正虚邪实证:5、气虚感冒-益气解表-参苏饮若平素表虚自汗,易受风邪者-玉屏风散阳虚-再造散6、阴虚感冒-滋阴解表-加减葳蕤汤二、咳嗽基本病机:外邪侵袭或脏腑功能失调导致肺失宣肃,肺气上逆。病位:主要在肺,与肝、脾、肾关系密切。A 外感咳嗽1、风寒袭肺-
2、疏风散寒、宣肺止咳-三拗汤合止咳散2、风热犯肺-疏风清热、宣肺化痰-桑菊饮夏令夹暑+六一散、鲜荷叶3、风燥伤肺-疏风清肺、润肺止咳-桑杏汤若凉燥证(燥证+风寒)-杏苏散B 内伤咳嗽1、痰湿蕴肺-健脾燥湿、化痰止咳-二陈平胃散合三子养亲汤2、痰热郁肺-清热化痰,肃肺止咳-清金化痰汤3、肝火犯肺-清肺平肝、顺气降火-泻白散合黛蛤散4、肺阴亏耗-滋阴清热,润肺止咳-沙参麦冬汤5、肺气亏虚-补肺益气,止咳化痰-补肺汤三、哮病基本病机:诱因【外邪侵袭、饮食不当、情志失调、劳倦失养】引触伏痰、痰阻气道、气道挛急,肺失肃降。病位:在肺-涉及脾肾-甚则累及于心。A、发作期1、冷哮-温肺散寒、化痰平喘-射干麻黄
3、汤2.热哮-清热宣肺、化痰定喘-定喘汤3.寒包热哮-解表散寒,化痰清热-小青龙加石膏汤或厚朴麻黄汤4.风痰哮-祛风涤痰,降气平喘-三子养亲汤5.虚哮-补肺纳肾,降气平喘-平喘固本汤B、缓解期1、肺脾气虚-补肺固卫,补土生金-六君子汤加味2.肺肾两虚-补肺益肾-生脉地黄汤合金水六君煎四、喘证基本病机:肺气升降出纳失常。实证:邪气壅塞、肺气不利虚证:肺不主气,肾失摄纳。病位:肺为气之主,肾为气之根。A、实喘1、风寒壅肺-祛风散寒,宣肺平喘-麻黄汤合华盖散2、表寒肺热-解表清里,宣肺平喘-麻杏石甘汤3、痰热郁肺-清热化痰,泻肺平喘-桑白皮汤4、痰浊阻肺-祛痰降逆,宣肺平喘-二陈汤合三子养亲汤5、肺气
4、郁闭-开郁降气平喘-五磨饮子B、虚喘1、肺虚-补肺益气,敛肺平喘-补肺汤中气虚弱,脾肺同病(食少便溏腹中气坠)-补中益气汤中医内科学总结2、肾虚-补肾纳气-金匮肾气丸合参蛤散肾阴虚-七味都气丸+生脉散3、正虚喘脱-扶阳固脱,镇摄纳气-参附汤送服黑锡丹配合蛤蚧粉五、肺痈基本病机:外邪犯肺,致热壅血瘀、润酿成痈、血败肉腐、化脓成痈。病位:肺部。1、初期-疏风散热,宣肺化痰-银翘散2、成痈期-清热解毒,化瘀消痈-千金苇茎汤合如金解毒散3、溃脓期-清热解毒,化瘀排脓-加味桔梗汤4、恢复期-益气养阴,清热排脓-沙参清肺汤或桔梗杏仁煎第二单元心脑系病证一、心悸基本病机:气血阴阳亏虚、心失所养、或邪扰心神、
5、心神不宁。病位:心、与脾肾肺肝四脏器密切相关。1、心虚胆怯-镇惊定志、养心安神-安神定志丸2、心血不足-补血养心,益气安神-归脾汤若见心动悸脉结代者-用炙甘草汤3、阴虚火旺-滋阴降火、养心安神-天王补心丹合朱砂安神丸4、心阳不振-温补心阳,安神定悸-桂枝甘草龙骨牡蛎汤合参附汤5、水饮凌心-振奋心阳,化气行水-苓桂术甘汤若心功能不全而导致浮肿,尿少,阵发性夜间咳喘或端坐呼吸-真武汤6、瘀阻心脉-活血化瘀、理气通络-桃仁红花煎合桂枝甘草龙骨牡蛎汤7、痰火扰心-清热化痰,宁心安神-黄连温胆汤二、胸痹基本病机:心脉痹阻病位:心,肝脾肾三脏功能失调有关本虚:气虚、阳虚、气阴两虚标实:血瘀、寒凝、痰浊、气
6、滞。1、心血瘀阻-活血化瘀、通脉止痛-血府逐瘀汤2、气滞心胸-疏肝理气,与血舒脉-柴胡疏肝散3、寒凝心脉-辛温散寒、宣痹通阳-枳实薤白桂枝汤合当归四逆汤若阴寒极盛,胸痹重证(心痛彻背,背痛彻心)-乌头赤石脂丸+苏合香丸4、痰浊闭阻-通阳泄浊、豁痰宣痹-瓜萎薤白半夏汤合涤痰汤5、心肾阴虚-滋阴益肾、养心与络-天王补心丹合炙甘草汤6、心肾阳虚-温补阳气、振奋心阳-参附汤合右归饮若肾阳虚衰,不能制水,水气凌心-心悸喘促,不能平卧,小便短少,肢全浮肿-真武汤7、气阴两虚-益气养阴、活血通络-生脉散合人参养营汤四、不寐基本病机:阳盛阴衰、阴阳失交、阳不入阴、心神失养或心神不宁。病位:心,肝脾肾胃有关1
7、肝郁化火-清肝化或,佐以安神-龙胆泻肝汤加味若头晕目眩,头痛欲裂,不寐烦躁大便秘结当归龙荟丸2 痰热内扰-清热化痰,与中安神-黄连温胆汤加味若痰食阻滞,胃中不与者+半夏秫米汤3、心火炽盛-清心泻火,安神宁心-朱砂安神丸4、阴虚火旺-滋阴降火,交通心肾-六味地黄丸合交泰丸加味5、心脾两虚-补养心脾,养血安神-归脾汤6、心胆气虚-益气镇惊,安神定志-安神定志丸合酸枣仁汤五、头痛基本病机:外感:风寒湿热外邪、上扰清窍、清窍不利。内伤:肝脾肾功能失调,风火痰瘀上扰清窍,气血阴精亏损,清窍失养。文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6
8、B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H
9、9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W
10、5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6
11、Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N
12、8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J1
13、0W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4
14、F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5中医内科学总结病位:脑,肝脾肾三脏有关A 外感1、风寒头痛-疏风散寒止痛-川芎茶调散若寒客少阴经脉-麻黄附子细辛汤若寒邪侵犯厥阴经(巅顶头痛、干呕吐涎沫,甚则四肢厥冷,苔白脉弦)-吴茱萸汤2、风热头痛-疏风清热与络-芎芷石膏汤若大便秘结,口鼻生疮,腑气不通者+黄连上清丸3、风湿头痛-祛风胜湿通窍-羌活胜湿汤B 内伤1、肝阳头痛-平肝潜阳息风-天麻钩藤饮2、痰浊头痛-健脾燥
15、湿,化痰降逆-半夏白术天麻汤3、瘀血头痛-活血化瘀通窍止痛-通窍活血汤4、肾虚头痛-养阴补肾,填髓生津-大补元煎若肾阴虚用知柏地黄丸5、血虚头痛-养血滋阴,与络止痛-加味四物六、眩晕基本病机:虚者:髓海不足、气血亏虚、清窍失养。实者:风火痰瘀扰乱清空。病位:脑(清窍),肝脾肾三脏有关1、肝阳上亢-平肝潜阳、滋养肝肾-天麻钩藤饮2、气血亏虚-补养气血、健运脾胃-归脾汤加味3、肾精不足:阴虚-补肾滋阴-左归丸阳虚-补肾助阳-右归丸4、痰浊中阻-燥湿祛痰、健脾与胃-半夏天麻白术汤若痰阻气机,郁而化火(头目胀痛,心烦口苦,渴不欲饮,苔黄腻,脉弦滑)-黄连温胆汤5、瘀血阻窍-祛瘀生新,通窍活络-通窍活血
16、汤七、中风基本病机:脏腑阴阳失调,气血逆乱,上冲犯脑及风火痰瘀横窜经络。病位:脑(清窍),心肝脾肾三脏有关诊断要点:猝然昏扑、不省人事、半身不遂、偏身麻木、口舌歪斜、言语晦涩、不能言语。（一）中经络1、风痰入络-祛风化痰通络-化痰通络汤2、风阳上扰-平肝潜阳,活血通络-天麻钩藤饮3、阴虚风动-滋阴潜阳,息风通络-镇肝熄风汤4、痰热腑实-化痰通腑泄热-星篓承气汤（二）中脏腑1、闭证-阳闭证候 辛凉开窍化痰,清肝息风-羚角钩藤汤合安宫牛黄丸2、闭证-阴闭 辛温开窍,化痰醒神-涤痰汤合苏合香丸3、脱证-阳闭证候 回阳救逆,益气固脱-急用参附汤合生脉散加味（三）后遗症1、风痰瘀阻-搜风化痰,行瘀通络-
17、解语丹2、气虚络瘀-益气行血,化瘀通络-天麻钩藤饮3、肝肾亏虚-滋养肝肾-左归丸合地黄饮子第四单元脾胃病证一、胃痛基本病机:外邪犯胃、饮食伤胃、情志所伤、导致胃气失与、气机不利。-不通则痛。脾胃虚弱:所致胃失濡养,温煦,不荣亦痛。病位:胃,肝脾有关1、寒邪客胃-温胃散寒、理气止痛-香苏散合良附丸加味2、饮食停滞-消食导滞、与胃止痛-保与丸文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG
18、3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1
19、N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L
20、5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:
21、CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 H
22、P1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI
23、9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编
24、码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5中医内科学总结3、肝气犯胃-疏肝解郁、理气解郁-柴胡疏肝散4、肝胃郁热-疏肝泄热,与胃止痛-丹栀逍遥散或化肝煎5、湿热中阻-疏肝泄热与胃-清中汤6、瘀血停滞-化瘀通络,与胃止痛-失笑散合丹参饮7、脾胃虚寒-温中健脾,与胃止痛-黄芪建中汤8、胃阴亏虚-养阴益胃,与中止痛-一贯煎合芍药甘草汤二、呃逆基本病机:胃失与降,胃气上逆动膈。病位:病位在膈,病变的关键脏腑在胃,还与肝脾肺肾诸脏腑有关。A 实证1 胃中寒冷:温中散寒,降逆止呃丁香散2、饮食停滞-消食导滞,降逆止呃-保与丸3、胃火上逆:清降泄热,降逆止呃竹叶石膏汤4、气
25、机郁滞:顺气解郁,与胃降逆五磨饮子5、痰饮内阻-降逆化痰,与胃止呕-旋覆代赭汤B 虚证1 脾胃阳虚-温补脾胃,与中降逆-理中丸2 胃阴不足-生津生津,降逆止呃-益胃汤加味三、泄泻基本病机:脾胃受损,湿困脾土,传导失司。病机关键:脾虚湿盛。病位:病位在脾胃与大小肠,与肝肾关系密切。(一)暴泻1 寒湿内盛-芳香化湿,疏表散寒-藿香正气散2 湿热伤中-清热利湿-葛根黄芩黄连汤3 食滞胃肠-消食导滞-保与丸(二)久泻1 肝气乘脾-抑肝扶脾-痛泻要方2 脾胃虚弱-健脾益气,化湿止泻-参苓白术散3 肾阳虚衰-温肾健脾、涩肠止泻-四神丸四、便秘基本病机:大肠传导失司。病位:大肠,但常与脾胃肺肝肾关系密切。(
26、一)实秘 1 热秘-泻热导滞,润肠通便-麻子仁丸2 气秘-顺气导滞-六磨汤3 冷秘-温里散寒,通便止痛-温脾汤合半硫(二)虚秘1 气虚便秘-补气润肠-黄芪汤2、血虚便秘-养血润燥润肠丸3、阴虚便秘-滋阴通便-增液汤4、阳虚便秘-温阳通便-济川煎第五单元肝胆病证一、胁痛基本病机:肝络失与,“不通则痛”与“不荣则痛”。病位:肝胆,又与脾胃肾有关。1 肝气郁结-疏肝理气-柴胡疏肝散2 瘀血阻络-活血化瘀,通络止痛-血府逐瘀汤或复元活血汤3 肝胆湿热-清热肝胆利湿-茵陈蒿汤合大柴胡汤4 肝阴不足-养阴柔肝-一贯煎二、黄疸基本病机:湿邪困遏脾胃,雍阻肝胆,肝胆脾胃功能失调,胆道失疏,胆汁外溢发黄。形成关
27、键:湿邪。病位:肝胆,又与脾胃肾有关。文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M
28、5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG
29、3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1
30、N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L
31、5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:
32、CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 H
33、P1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5中医内科学总结(一)阳黄1 热重于湿-清热通腑,利湿退黄-茵陈蒿汤2 湿重于热-利湿化浊运脾、佐以清热-茵陈五苓散合甘露消毒丹3 胆腑郁热-疏肝利胆,泄热退黄-大柴胡汤4 急黄(疫毒炽盛)-清热解毒,凉营开窍-犀角散(二)阴黄
34、:1 寒湿阻遏-温化寒湿、健脾与胄-茵陈术附汤2 脾虚湿滞-健脾养血,利湿退黄-黄芪建中汤第六单元肾系病症一、水肿基本病机:肺失通调,脾失转输,肾失开阖,三焦化气不利。病位:肺脾肾三脏有关,以肺为标,以脾为制水之脏。A 阳水1、风水相搏-疏风解表,宣肺行水-越婢加术汤2、湿毒浸淫-宣肺解毒、利湿消肿-麻黄连翘赤小豆汤+五味消毒饮3、水湿浸渍-运脾化湿、通阳利水-五皮饮+胃苓汤4、湿热壅盛-分利湿热-疏凿饮子B 阴水1、脾阳虚衰-健脾温阳利水-实脾饮2、肾阳衰微-温肾助阳,行气行水-济生肾气丸合真武汤3、瘀水互结-活血祛瘀,化气行水-桃红四物汤合五苓散二、淋证基本病机:湿热蕴结下焦,膀胱气化不利
35、。病机关键:脾肾两虚,肾与膀胱气化无权。病位:在膀胱与肾,且与肝脾密切相关。1 热淋-清热利湿通淋-八正散2 石淋-清热利湿,排石通淋-石苇散3 气淋实证-利气疏导,利尿通淋-沉香散虚证-补中益气-补中益气汤4 血淋实证-清热通淋、凉血止血-小蓟饮子虚证-滋阴清热、补虚止血-知柏地黄丸5 膏淋实证-清热利湿、分清泄浊-程氏萆薢分清饮虚证-补虚益肾固涩-膏淋汤6 劳淋:健脾益肾无比山药丸三、癃闭基本病机:肾与膀胱气化功能失常。病位:主要在肾与膀胱,但与三焦、肺、脾、肝密切相关。1 膀胱湿热-清热利湿、通利小便-八正散2 肺热壅盛-清泻肺热、通利水道-清肺饮3 肝郁气滞-疏肝理气、通利小便-沉香散
36、4 浊瘀阻塞-行瘀散结、通利水道-代抵当丸5 脾气下陷-升清降浊、化气利水-补中益气汤+春泽汤6 肾阳衰惫-温补肾阳,化气利水-济生肾气丸外治法:1 取嚏或探吐法2 外敷法3 针炙推拿4 导尿法第七单元气血津液病证一、郁证基本病机:气机郁滞。病位:主要在肝,与心脾肾密切相关。1 肝气郁结-疏肝解郁、理气畅中-柴胡疏肝散2 气郁化火-疏肝解郁、清热泻火-丹栀逍遥散3 痰气郁结-行气开郁、化痰散结-半夏厚朴汤4 心神失养-甘润缓急、养心安神-甘麦大枣汤文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L
37、5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:
38、CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 H
39、P1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI
40、9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编
41、码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6
42、 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9
43、ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5中医内科学总结5 心脾两虚-健脾养心、补血益气-归脾汤6 阴虚火旺-滋阴清热、养心安神-天王补心丹合六味地黄丸7、肝阴亏虚-滋养肝肾、清热安神-滋水清肝饮二、痰饮基本病机:肺脾肾功能失调,三焦气化不利,津液停聚。病位:主要在肺脾肾及三焦,可影响到五脏。A、痰饮1 脾阳虚弱-温脾化饮-苓桂术甘汤合小半夏加茯苓汤2 饮留胃肠-攻下逐饮-甘遂半夏汤或已椒苈黄丸B、悬饮1 邪犯胸肺-与解宣利-柴枳半夏汤2 饮停胸胁-
44、逐水祛饮-十枣汤/控涎丹3 络气不与-理气与络-香附旋覆花汤4 阴虚内热-滋阴清热-沙参麦冬汤合泻白散C、溢饮发表化饮-小青龙汤D、支饮1 寒饮伏肺-温肺化饮-小青龙汤2 脾肾阳虚-温补脾肾,以化水饮-金匮肾气丸合苓桂术甘汤三、消渴基本病机:阴津亏损,烦躁偏盛。以阴虚为本,燥热为标,两者互为因果。阴愈虚则燥热愈盛,燥热愈盛则阴愈虚。病位:主要在肺、胃(脾)、肾,尤以肾为关键。A 上消(肺热津伤)-清热润肺、生津止渴-消渴方加减B 中消:1 胃热炽盛-清胃泻火、养阴增液-玉女煎加减2 气阴亏虚-益气健脾,生津止渴-七味白术散加味C 下消:1 肾阴亏虚-滋阴固肾-六味地黄丸加减2 阴阳两虚-温阳滋
45、阴,补肾固摄-金匮肾气丸兼证治疗:白内障、雀目、耳聋-杞菊地黄丸或明目地黄丸疮疡、痈疽:初起-五味消毒饮四、虚劳基本病机:脏腑亏损,气血阴阳虚衰,久虚不复。病位:涉及五脏,尤其与先天之本肾与后天之本脾关系密切。A 气虚1 肺气虚-补益肺气-补肺汤2 脾气虚-健脾益气-加味四君子汤3 心气虚-益气养心-七福饮4 肾气虚-益气固肾-大补元煎B 血虚1 心血虚-养血宁心-养心汤2 肝血虚-补血养肝-四物汤C 阴虚1 肺阴虚-养阴润肺-沙参麦冬汤2 心阴虚-滋阴养心-天王补心丹3 脾胃阴虚-养阴与胃-益胃汤4 肝阴虚-滋养肝阴-补肝汤5 肾阴虚-滋补肾阴-左归丸D 阳虚1 心阳虚-益气温阳-保元汤2
46、脾阳虚-温中健脾-附子理中汤3 肾阳虚-温补肾阳-右归丸第八单元肢体经络病证一、痹证基本病机:风寒湿热痰瘀等邪气滞留肢体筋脉、关节、肌肉,病位:主要在肺、胃(脾)、肾,尤以肾为关键。1 风寒湿痹(痛痹)-散寒通络,祛风除湿-乌头汤文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N
47、8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5
48、M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:C
49、G3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP
50、1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9L5M5J10W5文档编码:CG3T4F6Z6B6 HP1N8S9N8H9 ZI9