张建平从脏腑经络论治咽异感症

Zhang Jianping’s Treatment of Pharyngeal Paraesthesia from the Perspective of Zang-Fu Organs and Meridians

摘要: 咽异感症是临床常见病症，属中医“梅核气”范畴，以咽喉部非疼痛性异物感为主要表现，多与情志失调、脏腑功能紊乱相关。本文基于张建平主任医师的临床经验，探讨从脏腑经络整体观论治咽异感症的辨证思路与用药特色。研究指出，梅核气的核心病机为肝郁气滞、痰气交阻，兼有心肾不交、虚阳浮越等复杂证候。张建平提出“心肾同调，疏肝健脾”的治法，以交泰丸为基础方，结合疏肝解郁、健脾化痰药物，调和阴阳、畅通气机，实现多脏同治。并附运用张建平主任自拟方治验1则，以示对临床的治疗意义和实用价值。

Abstract: Pharyngeal paraesthesia is a common clinical condition falling within the scope of “Plum Pit Qi” (Mei He Qi) in traditional Chinese medicine (TCM). Characterized by non-painful foreign body sensation in the throat, it is often associated with emotional dysregulation and visceral dysfunction. Drawing on the clinical experience of Chief Physician Zhang Jianping, this paper explores the syndrome differentiation and medication strategies for treating pharyngeal paraesthesia from the holistic perspective of Zang-Fu organs and meridians. The study identifies the core pathogenesis as stagnation of liver qi and intermingling of phlegm and qi, often accompanied by disharmony between the heart and kidney and floating of deficient yang. Zhang advocates the therapeutic principle of “regulating both the heart and kidney, soothing the liver and strengthening the spleen”, using Jiaotai Wan (Jiaotai Decoction) as the foundational formula combined with herbs for resolving liver stagnation, invigorating the spleen, and dissipating phlegm to harmonize yin and yang, promote qi circulation, and treat multiple organs simultaneously. A case report using Zhang’s self-formulated prescription is presented to demonstrate its clinical significance and practical value.