海派伤寒名家包识生经方五字辨治鼻炎及特色鼻塞疗法介绍
摘要：海派中医伤寒名家包识生及学术经方五字辨治概述，中医“气、血、精、痰、饮”五字（物质）辨证论治，直抓人体疾病的本质表现和主要矛盾进行辨证论治，有“直捣黄龙”和“一针见血”之妙。它是包师经方整体观的继承和创新，更是医圣张仲景辨证论治理论的继承和升华。《包氏医宗》中指出鼻炎诊治以涕为要，清涕（寒性）宜收，脓涕（热性）宜排，为两大治纲。以气血精痰饮五字整体分析组方，总以止涕、通鼻、消痒为主要治法。内服加外用分别治之，疗效显著。
关键词：包识生；经方五字辨治；气血精痰饮；鼻炎；塞鼻疗法
Introduction of five-character Syndrome differentiation and treatment of rhinitis and characteristic nasal obstruction therapy in baoshisheng classic prescription
Bao Yonghui, Yueqing Development Area Hospital
ABSTRACT: The five-character Syndrome differentiation of Qi, blood, essence, phlegm and fluid in traditional Chinese Medicine (TCM) is based on the essence and main contradiction of human disease, there is "straight to the Yellow Dragon" and "hit the nail on the head" wonderful. It is not only the inheritance and innovation of the holistic view of Baoshi's classic prescriptions, but also the inheritance and sublimation of the theory of treatment based on differentiation of symptoms and signs of Saint Zhang Zhongjing. "Bao's medical cases" in the diagnosis and treatment of rhinitis to Snot, clear snot (cold) should be collected, purulent snot (hot) should be discharged, for the two programmes. To qi-xue-jing-tan-yin five-word overall analysis of the group, the total to stop runny, Tongbi, Xiaoyang as the main treatment. Internal and External Treatment Respectively, the curative effect is significant.
Key Words: Baozhisheng; five-character treatment of classical prescriptions; qi-blood-jing-tan-yin; rhinitis; nasal obstruction therapy
1. 包识生及学术经方五字辨治概述
包识生，清末民初享誉福建、上海的中医名家。在沪行医与诸名医创办医学会、医学校，培养了大批的诸如秦伯未、章次公、程门雪等中医名家。识生学术代表《包氏医宗》崇尚伤寒经方，治学严谨，堪称现代中医院校教材雏形。包师强调学习研究运用《伤寒论》要遵循经方的整体效应。依据“精、气、血、津液”是人体构成和维持生命活动的基本物质，和“痰湿、水饮、瘀血”是人体生理病理的基本产物的论述，大胆创立中医“气、血、精、痰、饮”五字（物质）辨证论治，直抓人体疾病的本质表现和主要矛盾进行辨证论治，有“直捣黄龙”和“一针见血”之妙。它是包师经方整体观的继承和创新，更是医圣张仲景辨证论治理论的继承和升华。
2. 《包氏医宗》中鼻炎的经典论述。
肺气开窍于鼻，肺有病则鼻为之应，鼻孔为肺之外候。鼻流清涕之鼻塞，为风寒伤表之寒症也。若鼻流浊涕，则又为肺中寒症矣。按：涕非痰可比也，涕由鼻出，痰由肺来而从口出，故涕浊为肺寒，痰浊为肺热。鼻有涕为寒症，鼻干无涕且燥，是肺热内闭也。故鼻炎诊断中判断寒热标准为：有涕，不分清浊均为寒，有涕兼有浊痰（常称鼻涕倒流咽喉）均为热，无涕鼻干，甚出血，为热。鼻炎治疗均在治肺为标。
涕多纲目本在脾虚湿泛，太阴病湿，脉浮，病在手太阴肺也，可发汗，宜桂枝汤，又按《杂病论》第二篇第二章卫湿节论治“纳药鼻中，散其卫湿”；自利不渴，病太阴脾宜服理中。太阴传变有二，阴化为少阴自利，而用四逆辈。另阳化传变为阳明便硬，用大承气，此为鼻干纲目。鼻干燥衄血，为阳明胃热经病白虎汤用之。
鼻塞纲目有二，一为肺卫湿犯，以桂枝汤论治“纳药鼻中，散其卫湿”，二为肺胃有热，鼻甲肥肿致塞，易清热解毒凉血化瘀消肿论治。
鼻痒纲目风为作痒，风寒风热兼夹湿邪侵犯肺卫，正所谓是“无风无湿不作痒”，鼻痒而作喷嚏。宜用防风、紫苏叶、蝉衣、僵蚕、地龙、全蝎等祛风止痒。
