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傳統中醫如何診治肝病­-馬光亞教授之臨床經驗與思路探討

已故 馬教授光亞先生(以下臨文不諱)是台灣中醫界治療肝病的泰斗,更是台灣唯一經大陸中醫界肯定並評選為「中國百年中醫臨床家」者。

  馬教授雖已有肝病專書,但自民國八十八年以後的醫案就未再整理,如此對其學術研究並不完整。筆者有幸於馬教授晚年跟診三年,發現其診療思路仍有新的進展,應予整理歸納。

  本研究涵蓋所有馬教授肝病治療的醫案與論述。筆者反覆研究馬教授已出版的肝病相關文章與專書,並進行醫案分析。在此基礎上和晚年肝病病歷交叉分析並考察其學術源流。初步歸納出馬教授的肝病診察綱領、治法要點、處方原則、兼證治法,與常用之經方、時方、藥對、草藥的使用要點。並探討其如何面對西醫檢驗數據與進行中西醫配合。嘗試從思想史分期的觀點,剖析其診療肝病思路的轉變歷程。 

  馬教授在台灣診治肝病近半世紀的研究歷程與經驗,可提供中醫界治療肝病的指引與研發基礎,更可作為應對新興疾病時的借鏡。

關鍵詞:馬光亞 肝病 中醫藥

ABSTRACT
The late Professor Ma Guang-Ya was a leading authority in the Chinese medical treatment of liver diseases in Taiwan. Furthermore, he was the only person on this island ever elected the “Chinese Medical Clinicial of the Century” by mainland Chinese medicine circles.
Though Ma produced many treatises on liver diseases, his medical case stories after 1999 have not been arranged and analyzed, so that academic study of his works is incomplete. I was fortunate enough to spend three years studying under Professor Ma in clinic during his later years. During that time, I discovered advances in his medical thinking that merit study.
This study covers all therapeutic case stories and expositions made by Ma. I studied Ma's works relating to liver disease in great detail and analyzed his case histories. This allowed me then to make cross analyses with case histories recorded in his later life and understand their academic origins. The study describes Ma's diagnostic and therapeutic practices, his prescription principles, his methods of dealing with secondary patterns, the classic formulas and latterday formulas (those post-daint Zhang Ji), the medicinal couplets, and the popular herbs that he commonly used in the treatment of liver disease. Furthermore, it investigates the application of modern medical testing and integrated Chinese and Western treatment. Finally, it analyzes the evolution of Ma’s thinking on liver disease over time.
Based on half a century of study and experience in treating the liver diseases, Ma’s work provides guidance for the treatment of liver disease and a basis for further development of knowledge. Furthermore, it provides a framework for coping with new diseases.
Key words: Ma Guang-Ya, liver disease, Chinese medicine

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