宋金元时期心悸病证治特点探析

Analysis on the characteristics of syndrome and treatment in palpitation during the Song，Jin，and Yuan Dynasties

关键词:  宋金元时期  心悸  中医  证治特点

Key words:  Song Jin Yuan Dynasties  palpitations  traditional Chinese medicine  characteristics of syndrome and treatment

摘要:

宋金元时期心悸病的证治理论得到极大的丰富和完善。北宋时期，心悸病的发展多承晋唐“类分”思想之遗风，医家们注重对前朝医药理论的整理和继承，但又有所发挥。北宋医者新提出时气热毒、热邪两种病因，补入心实热、心中风和肾虚 3 种脏腑证型，扩充了他病致悸的种类，心悸的通用药物被首次提出，历代效验方在方书中也得到全面的总结和整理。南宋时期，医家们受理学影响本经典、重求理，对心悸的病名和分类方式进行规范，发挥火热、脾胃气虚、血虚、气郁、痰浊等病机，并对心悸方剂进行精简，创立诸多名方，同时注重用药的次第问题，丰富了心悸的治法治则。纵观宋金元时期，心悸病的部分用药存在古今变迁，需要给予足够的重视；对病机的理解及治法用药亦与当代不同，值得学习与借鉴。

Abstract:

The syndrome and treatment theory of palpitations during the Song，Jin，and Yuan Dynasties has been greatly enriched and improved. During the Northern Song Dynasty，the development of palpitations mostly inherited the legacy of the “classification” ideology of the Jin and Tang Dynasties. Doctors emphasized the organization and inheritance of the medical theories of the previous dynasties，but they also exerted some influence. Medical practitioners in the Northern Song Dynasty proposed two new causes，qi heat toxin and heat evil，and three types of visceral syndromes，heart excess heat，heart wind，and kidney deficiency. This expanded the types of palpitations caused by other diseases，and universal drugs for palpitations were first proposed. Effective prescriptions from previous dynasties were also comprehensively summarized and organized in prescriptions. During the Southern Song Dynasty，doctors accepted the influence of classical medicine and focused on seeking truth. They standardized the name and classification of heart palpitations，taking into account the pathogenesis of fire heat，spleen and stomach qi deficiency，blood deficiency，qi stagnation，and phlegm turbidity. They also simplified the formulas for heart palpitations，created many famous formulas，and focused on the secondary issue of medication，enriching the treatment principles of heart palpitations. Throughout the Song，Jin，and Yuan Dynasties，some medications for palpitations have undergone changes from ancient to modern times and require sufficient attention. The understanding of the pathogenesis and treatment methods and medication are also different from contemporary ones，and it is worth learning and using for reference.