蒋啸　郑旭锐

摘要 目的：为了解决目前消化系统疾病所面临的传统化学药物难以解决的临床问题，撷取叶天士治疗胃腑“以通为和、以降为顺”的认识为基础为临床应用生物药物提出新的解决策略。方法：爬梳叶氏取法金元、新安名家，底柢仲景、化裁经方的学术源流沿革与其在消化系统疾病中的现实意义，使用“模式构建”与“降维升阶”的方法，梳理叶天士通治胃腑的立法思想。结果：构建了以胃气、胃阴、胃阳为基础的“胃腑犄角模式”。结论：治疗消化系统疾病可根据“胃腑犄角模式”，先将胃气、胃阴、胃阳作为据证立法的抓手进行考量，再结合叶氏使用茯苓、生姜、扁豆、沙参的经验，并最终做出符合病家个体特色的临床决策与治疗方案的诊疗模式。

关键词 通补胃腑; @ 叶天士;模式构建;源流疏证;学术探讨;脾胃分治;诠释学;文献研究

New Interpretation of Supplement Stomach-fu Organ Model of YE Tianshi Tong

JIANG Xiao，ZHENG Xurui

（Shaanxi University of Chinese Medicine，Xianyang 712046，China）

Abstract Objective：In order to solve the difficult clinical problems of traditional chemical drugs in digestive system diseases，using YE Tianshi thinking on treating stomach organs “Fu organs as the base，which were remvoing obstrcution as harmony and decline as smooth”，providing a new solution strategies for clinical application of biopharmaceuticals.Methods：By using Pashu Yeshi method，Jinyuan，Xinan famous masters，Didi Zhongjing，and Huacai Prescription，the paper discussed the evolution of academic sources and their practical significance in digestive system diseases，using the methods of “model construction” and “reducing dimension and ascending step ”，and combed the legislative thought of YE Tianshi tong′s treatment of stomach and viscera.Results：Try to construct the model of “the angle of the stomach-fu organs” based on stomach qi，stomach yin and stomach yang.Conclusion：It is proposed that in the treatment of digestive system diseases，according to the “angle pattern of stomach-fu organs”，the stomach qi，stomach yin and stomach yang can be considered as the grip of the evidence legislation，and then can combined with the experience of using Poria，Rhizoma Zingiberis Recens，Semen Dolichoris Album and Radix Adenophorae by YE′s family，and finally the clinical decision and treatment mode which accord with the individual characteristics of the patient and the treatment plan was made.

Keywords Dissapte and supplement stomach-fu organ model; @ YE Tianshi; Model construction; Origin and development thinning syndrome; Academic research; Treating spleen and stomach separately; Elaboration; Literature research

中圖分类号：R249;R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.15.028

我国是消化系统疾病发病大国，每年社会经济与家庭个人都承受极大影响。研究消化系统疾病时不免要对炎癌转变、氧化应激等机制进行深入探讨。随着研究的不断深入，越来越多的学者不再将目光局限于传统化学药物，而转向利用生物药物对疾病进行干预。传统医学在利用生物药物上有着丰富的经验，其又尤以叶天士对胃腑诊疗经验与用药特色为集大成者。通过对传统医学胃腑诊疗沿革和叶天士胃腑诊疗特色的爬梳，希冀对胃腑治疗进行模式构建。使传统医学的医疗经验能反哺于科研与临床，从而进行更加细化与精准的研究。……