七版中医内科证型整理.docx

七版中医内科证型整理.docx

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七版中医内科证型整理

七版中医内科证型整理

      类  型      证  型      治      法      舌    脉      方      药

感冒          风寒束表      辛温解表      苔薄白，脉浮紧      荆防达表汤、荆防败毒散

          风热犯表      辛凉解表      舌边尖红，苔薄黄，脉浮数      银翘散、葱豉桔梗汤

          暑湿伤表      清暑祛湿解表      苔薄黄而腻，脉濡数      新加香薷饮

          气虚感冒      益气解表      舌淡苔白，脉浮无力      参苏饮

          阴虚感冒      滋阴解表      舌红少苔，脉细数      加减葳蕤汤

咳嗽      外  感      风寒袭肺      疏风散寒，宣肺止咳      苔薄白，脉浮或浮紧      三拗汤合止嗽散

          风热犯肺      疏风清热，宣肺止咳      苔薄黄，脉浮数或浮滑      桑菊饮

          风燥伤肺      疏风清肺，润燥止咳      舌红少津，苔薄白或薄黄，脉浮数或

小数      桑杏汤

      内  伤      痰湿蕴肺      燥湿化痰，理气止咳      苔白腻，脉濡滑      二陈平胃散合三子养亲汤

          痰热郁肺      清热肃肺，豁痰止咳      舌红，苔薄黄腻，脉滑数      清金化痰汤

          肝火犯肺      清肝泻肺，顺气降火      苔薄黄少津，脉弦数      加减泻白散合黛蛤散

          肺阴亏耗      滋阴润肺，化痰止咳      舌红少苔，脉细数      沙参麦冬汤

哮病      发作期      寒（冷）哮      温肺散寒，化痰平喘      苔白滑，脉弦紧或浮紧      射干麻黄汤、小青龙汤

          热  哮      清热宣肺，化痰定喘      舌红，苔黄腻，脉滑数或弦滑      定喘汤、越婢加半夏汤

          寒包热哮      解表散寒，清热化痰      舌尖边红，苔白腻罩黄，脉弦紧      小青龙加石膏汤、厚朴麻黄汤

          风痰哮      祛风涤痰，降气平喘      苔厚腻，脉滑实      三子养亲汤

          虚  哮      补肺纳肾，降气化痰      舌淡，脉沈细      平喘固本汤

      缓解期      肺脾气虚      健脾益气，补土生金      舌淡苔薄白，脉细弱      六君子汤

          肺肾两虚      补肺益肾      舌红少苔，脉细数      生脉地黄汤合金水六君煎

喘证      实  喘      风寒壅肺      宣肺散寒      苔薄白而滑，脉浮紧      麻黄汤合华盖散

          表寒肺热      解表清里，化痰平喘      舌红，苔薄白或黄，脉浮数或滑      麻杏石甘汤

          痰热郁肺      清热化痰，宣肺平喘      舌红，苔黄或腻，脉滑数      桑白皮汤

          痰浊阻肺      祛痰降逆，宣肺平喘      苔白厚腻，脉滑      二陈汤合三子养亲汤

          肺气郁痹      开郁降气平喘      苔薄，脉弦      五磨饮子

      虚  喘      肺气虚耗      补肺益气养阴      舌淡红或舌红苔剥，脉软弱或细数      生脉散合补肺汤

          肾虚不纳      补肾纳气      舌红少津，脉细数      金匮肾气丸合参蛤散

          正虚喘脱      扶阳固脱，镇摄肾气          参附汤送服黑锡丹

肺胀          痰浊壅肺      化痰降气，健脾益肺      舌暗，苔薄腻或浊腻，脉小滑      苏子降气汤合三子养亲汤

          痰热郁肺      清肺化痰，降逆平喘      舌边尖红，苔黄或黄腻，脉数或滑数      越婢加半夏汤、桑白皮汤

          痰蒙神窍      涤痰，开窍，熄风      舌暗红或淡紫，苔白腻或黄腻，脉细

滑数      涤痰汤

          阳虚水泛      温肾健脾，化饮利水      舌胖黯，苔白滑，脉沈细      真武汤合五苓散

          肺肾气虚      补肺纳肾，降气平喘      舌淡或黯紫，脉沈细数无力或结代      平喘固本汤合补肺汤

肺痨          肺阴亏损      滋阴润肺      舌边尖红，苔薄白，脉细数      月华丸

          虚火灼肺      滋阴降火      舌干而红，苔薄黄而剥，脉细数      百合固金汤合秦艽鳖甲散

          气阴耗伤      益气养阴      舌光淡，边有齿痕，苔薄，脉细弱而数      保真汤、参苓白朮散

          阴阳虚损      滋阴补阳      舌光淡隐紫少津，苔黄而剥，脉微细

而数或虚大无力      补天大造丸

胸痹          心血瘀阻      活血化瘀，通脉止痛      舌紫黯有瘀斑，苔薄，脉沈涩      血府逐瘀汤

          气滞心胸      疏肝理气，活血通络      苔薄或薄腻，脉细弦      柴胡疏肝散

          痰浊闭阻      通阳泄浊，豁痰宣痹      舌胖大有齿痕，苔浊腻，脉滑      栝蒌薤白半夏汤合涤痰汤

          寒凝心脉      辛温通阳，开痹散寒      苔白，脉沈细      枳实薤白桂枝汤合当归四逆汤

          心肾阴虚      滋阴清火，养心和络      舌红少津或有紫斑，脉细带数或促代      天王补心丹合炙甘草汤

          气阴两虚      益气养阴，活血通络      舌淡红边有齿痕，脉细弱无力或结代      生脉散合人参养荣汤

          心肾阳虚      温补阳气，振奋心阳      舌淡胖或紫黯，脉沈细迟      参附汤合右归饮

心悸          心虚胆怯      镇惊定志，养心安神      苔薄白，脉细略数或细弦      安神定志丸

          心血不足      补血养心，益气安神      舌淡红，脉细弱      归脾汤

          阴虚火旺      滋阴清火，养心安神      舌红少津，少苔或无苔，脉细数      天王补心丹、朱砂安神丸

          心阳不振      温补心阳，安神定悸      舌淡苔白，脉虚弱或沈细无力      桂枝甘草龙骨牡蛎汤合参附汤

          水饮凌心      温阳利水，宁心安神      舌淡苔滑，脉弦滑或沈细而滑      苓桂朮甘汤

          瘀阻心脉      活血化瘀，理气通络      舌紫黯或有瘀斑，脉涩或结或代      桃仁红花煎合

桂枝甘草龙骨牡蛎汤

          痰火扰心      清热化痰，宁心安神      舌红，苔黄腻，脉弦滑      黄连温胆汤

胃痛          寒邪客胃      温胃散寒，行气止痛      舌淡苔薄白，脉弦紧      香苏散合良附丸

          饮食伤胃      消食导滞，和胃止痛      苔厚腻，脉滑      保和丸

          肝气犯胃      疏肝解郁，理气止痛      苔多薄白，脉沈弦      柴胡疏肝散

          湿热中阻      清化湿热，理气和胃      舌红苔黄腻，脉滑数      清中汤

          瘀血停胃      化瘀通络，理气和胃      舌黯，脉涩      失笑散合丹参饮

          胃阴亏耗      养阴益胃，和中止痛      舌红少津，脉细数      一贯煎合芍药甘草汤

          脾胃虚寒      温中健脾，和胃止痛      舌淡苔白，脉虚弱或迟缓      黄蓍建中汤

      类  型      证  型      治      法      舌    脉      方      药

泄泻      暴  泻      寒湿内盛      散寒化湿      苔白腻，脉濡缓      藿香正气散

          湿热伤中      清热利湿      舌红苔黄腻，脉滑数或濡数      葛根芩连汤

          食滞肠胃      消食导滞      舌苔垢浊或厚腻，脉滑      保和丸

      久  泻      脾胃虚弱      健脾益气，化湿止泻      舌淡苔白，脉细弱      参苓白朮散

          肾阳虚衰      温补脾肾，固涩止泻      舌淡苔白，脉沈细      四神丸

          肝气乘脾      抑肝扶脾      舌淡红，脉弦      痛泻要方

痢疾          湿热痢      清肠化湿，调气和血      苔黄腻，脉滑数      芍药汤

          疫毒痢      清热解毒，凉血除积      舌红绛，苔黄腻，脉滑数      白头翁汤合芍药汤

          寒湿痢      温中燥湿，调气和血      苔白腻，脉濡缓      不换金正气散

          阴虚痢      养阴和营，清肠化湿      舌红绛少津，苔腻或花剥，脉细数      黄连阿胶汤合驻车丸

          虚寒痢      温补脾肾，收涩固脱      舌淡，苔薄白，脉沈细而弱      桃花汤合真人养脏汤

          休息痢      温中清肠，调气化滞      舌淡苔腻，脉濡软或虚数      连理汤

腹痛          寒邪内阻      散寒温里，理气止痛      苔白腻，脉沈紧      良附丸合正气天香散

          湿热壅滞      泄热通腑，行气导滞      苔黄腻，脉濡数      大承气汤

          饮食积滞      消食导滞，理气止痛      苔腻，脉滑实      枳实导滞丸

          肝郁气滞      疏肝解郁，理气止痛      苔薄，脉弦      柴胡疏肝散

          瘀血内停      活血化瘀，和络止痛      舌质青紫，脉弦或涩      少腹逐瘀汤

          中虚脏寒      温中补虚，缓急止痛      舌淡，苔白，脉沈细      小建中汤

胁痛          肝郁气滞      疏肝理气      苔薄白，脉弦      柴胡疏肝散

          瘀血阻络      祛瘀通络      舌紫黯，脉沈涩      血府逐瘀汤、复元活血汤

          肝胆湿热      清热利湿      舌红，苔黄腻，脉弦滑      龙胆泻肝汤

          肝络失养      养阴柔肝      舌红，少苔，脉弦细数      一贯煎

黄疸      阳  黄      热重于湿      清热通腑，利湿退黄      舌红，苔黄腻，脉弦数      茵陈蒿汤

          湿重于热      利湿化浊，佐以清热      舌红，苔厚腻微黄，脉濡缓      茵陈五苓散合甘露消毒丹

          胆腑郁热      疏肝泄热，利胆退黄      舌红，苔黄，脉弦滑数      大柴胡汤

      急  黄      疫毒炽盛      清热解毒，凉血开窍      舌红绛，苔黄而燥，脉弦数或弦细数      《千金》犀角散

      阴  黄      寒湿阻遏      温中化湿，健脾和胃      舌胖大，苔白腻，脉濡缓      茵陈朮附汤

          脾虚湿滞      健脾养血，利湿退黄      舌淡，苔薄，脉濡细      黄蓍建中汤

      黄  疸

消退后      气滞血瘀      活血化瘀，疏肝理气      舌紫黯或有瘀斑，脉弦涩或细涩      逍遥散合鳖甲煎丸

          湿热留恋      清热利湿      苔腻，脉濡数      茵陈四苓散

          肝脾不调      调和肝脾，理气助运      苔薄白，脉细弦      柴胡疏肝散、归芍六君子汤

鼓胀          气滞湿阻      疏肝理气，运脾利湿      苔薄白腻，脉弦      柴胡疏肝散合胃苓汤

          水湿困脾      温中健脾，行气利水      苔白腻，脉缓      实脾饮

          水热蕴结      清热利湿，攻下逐水      舌边尖红，苔黄腻或灰黑，脉弦数      中满分消丸合茵陈蒿汤

          瘀结水留      活血化瘀，行气利水      舌紫黯或有瘀斑，脉细涩      调营饮

          阳虚水盛      温补脾肾，化气利水      舌胖紫，苔淡白，脉沈细无力      附子理苓汤、济生肾气丸

          阳虚水停      滋肾柔肝，养阴利水      舌红绛少津，苔少或光剥，脉弦细数      六味地黄丸合一贯煎

积聚      聚证      肝气郁结      疏肝解郁，行气散结      苔薄，脉弦      逍遥散合木香顺气散

          食滞痰阻      理气化痰，导滞散结      苔腻，脉弦滑      六磨汤

      积证      气滞血瘀      理气消积，活血散瘀      苔薄，脉弦      柴胡疏肝散合失笑散

          瘀血内结      祛瘀软坚，扶正健脾      舌紫黯或有瘀斑、瘀点，脉细涩      膈下逐瘀汤合六君子汤

          正虚瘀结      补益气血，活血化瘀      舌淡紫或光剥无苔，脉细数或弦细      八珍汤合化积丸

水肿      阳水      风水相搏      疏风清热，宣肺行水      舌红，苔薄白，脉浮滑数或浮滑或紧      越婢加朮汤

          湿毒浸淫      宣肺解毒，利湿消肿      舌红，苔薄黄，脉滑数      麻黄连翘赤小豆汤合五味消毒饮

          水湿浸渍      运脾化湿，通阳利水      苔白腻，脉沈缓      五皮饮合胃苓汤

          湿热壅盛      分利湿热      舌红，苔黄腻，脉沈数或濡数      疏凿饮子

      阴水      脾阳虚衰      健脾温阳利水      舌淡，苔白腻或白滑，脉沈缓或沈弱      实脾饮

          肾阳衰微      温肾助阳，化气行水      舌淡胖，苔白，脉沈迟无力      济生肾气丸合真武汤

          瘀水互结      活血祛瘀，化气行水      舌紫黯，苔白，脉沈细涩      桃红四物汤合五苓散

淋证          热  淋      清热利湿通淋      舌红，苔黄腻，脉濡数      八正散

          石  淋      清热利湿，排石通淋      新病      舌红，苔薄黄，脉弦或弦数      石苇散加

金钱草、海金砂、鸡内金

                      久病      舌淡有齿痕，脉细弱，或

舌红，少苔，脉细数      

          气  淋      理气疏导，通淋利尿      苔薄白，脉弦      沈香散

          血  淋      清热通淋，凉血止血      舌尖红，苔黄，脉滑数      小蓟饮子

          膏  淋      清热利湿，分清泄浊      舌红，苔黄腻，脉濡数      程氏萆薢分清饮

          劳  淋      健脾益肾      舌淡，脉虚弱      无比山药丸

      类  型      证  型      治      法      舌    脉      方      药

消渴      上  消      肺热津伤      清热润肺，生津止渴      舌边尖红，苔薄黄，脉洪数      消渴方

      中  消      胃热炽盛      清胃泻火，养阴增液      苔黄，脉滑实有力      玉女煎加黄连、栀子

          气阴亏虚      益气健脾，生津止渴      舌淡红，苔白而干，脉弱      七味白朮散

      下  消      肾阴亏虚      滋阴固肾      舌红，少苔，脉沈细数      六味地黄丸

          阴阳两虚      滋阴温阳，补肾固摄      舌淡，苔白，脉沈细无力      金匮肾气丸

瘿病          气郁痰阻      理气疏郁，化痰消瘿      苔薄白，脉弦      四海舒郁丸

          痰结血瘀      理气活血，化痰消瘿      舌暗或紫，苔薄白或白腻，脉弦或涩      海藻玉壶汤

          肝火旺盛      清肝泻火，消瘿散结      舌红，苔薄黄，脉弦数      栀子清肝汤合消瘰丸

          心肝阴虚      滋阴降火，定心柔肝      舌红，少苔或无苔，脉弦细数      天王补心丹、一贯煎

眩晕          肾精不足      滋补肝肾，益精填髓      舌淡苔白，脉弱或舌红少苔，脉细数      左归丸

          肝阳上亢      平肝潜阳，清火熄风      舌红，苔薄黄，脉弦细数      天麻钩藤饮

          气血亏虚      补益气血，调养心脾      舌淡嫩，苔薄白，脉细弱      归脾汤

          痰湿中阻      化痰祛湿，健脾和胃      舌胖大边有齿痕，苔白腻，脉濡滑      半夏白朮天麻汤

          瘀血阻窍      祛瘀生新，活血通窍      舌紫黯，有瘀斑或瘀点，脉弦涩或细涩      通窍活血汤

头痛      外  感      风寒头痛      疏风散寒止痛      舌淡红，苔薄白，脉浮紧      川芎茶调散

          风热头痛      疏风清热和络      舌边尖红，苔薄黄，脉浮数      芎芷石膏汤

          风湿头痛      祛风胜湿通窍      舌淡红，苔白腻，脉濡或滑      羌活胜湿汤

      内  伤      肝阳头痛      平肝潜阳熄风      舌红少苔或薄黄，脉弦或弦细数      天麻钩藤饮

          血虚头痛      滋阴养血，和络止痛      舌淡，苔薄白，脉细或细弱      加味四物汤

          肾虚头痛      补肾填精      舌红，苔薄白或少苔、剥苔，脉细数      大补元煎

          痰浊头痛      健脾燥湿，化痰降逆      舌淡红，苔白腻，脉滑或弦滑      半夏白朮天麻汤

          瘀血头痛