| 摘要: |
| 老年人群作为社会人群结构的重要组成部分，其体质特点在九种基本体质类型的基础上又有着特异性的方面，研究其体质特点对于老年人群的健康促进以及老年病的防治有着尤为重要的意义。叶天士在诊疗过程中十分重视患者体质特点，明确提出“平素体质不可不辨”，其对于老年人群的体质特点也有着深刻的认识。文章通过对《临证指南医案》中相关的老年病医案进行分析总结，将叶天士老年体质学术思想归纳为“阳明脉衰”“肾精亏耗”及“上实下虚”，并对老年体质特点不同方面相应的易发病证进行探讨，总结叶天士方药特点。发现叶天士对于老年病的辨治多从通补阳明与培补肝肾出发，针对老年体质与疾病的关系，调整攻补关系，体现“辨体-辨病-辨证”相结合的诊疗思路，对现代临床亦有重要价值。 |
| 关键词: 老年体质 辨体论治 叶天士 治则 治法 |
| DOI：10.11656/j.issn.1672-1519.2022.05.10 |
| 分类号:R22 |
| 基金项目:国家自然科学基金项目（81803970）；中央高校基本科研业务费专项资金（2019-JYB-TSXK-001，2020-JYB-XJSJJ-003）；中华中医药学会“青年人才托举工程”（CACM-2019-QNRC2-A01）；北京中医药大学“青年科学家培育计划”。 |
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| YE Tianshi’s academic thoughts on the constitution of elderly population and the exploration of corresponding therapeutic methods based on constitution-differentiation theory |
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MA Han1,2, GUO Wenqian1, WAN Jinyi1, YAO Haiqiang1
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1.Beijing University of Chinese Medicine, Beijing 100029, China;2.Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
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| Abstract: |
| The elderly,as an important part of the social population structure,have their own specific characteristics of body constitution besides nine basic constitution types. The study of their constitution features is particularly important for the health promotion and the prevention and treatment of the elderly. In the process of diagnosis and treatment,YE Tianshi attached great importance to the constitutional characteristics and clearly put forward that "constitution-differentiation is indispensable",he achieved an insightful understanding of the constitution characteristics of the elderly. By studying the relevant medical records of geriatric diseases in the Clinic Guideline of Medical Records,the author sums up the constitution of the elderly as"decline of Yangming Meridian""the element deficiency" and "upper excess and lower deficiency",and analyzes YE's prescriptions for the treatment of geriatric diseases,and then finds that YE's differentiation and treatment of geriatric diseases are mainly based on invigorating Yangming and nourishing the liver and kidney,and adjusts the relationship between attack and tonification in view of the relationship between constitution and disease of the elderly. It embodies the diagnosis and treatment idea of the combination of "constitution differentiation-disease differentiation-syndrome differentiation",which is also of great value to the modern clinic. |
| Key words: constitution of the elderly population constitution differentiation and treatment YE Tianshi therapeutic principle treatment method |
