《伤寒杂病论》下利证辨治分析
|
摘要
下利是中医临床的常见病证,《伤寒论》关于下利的条文84条,《金匮要略》关于下利条文42条(含复方条文)。条文分布于伤寒"六经病""霍乱病""呕吐哕下利病""腹满寒疝宿食病""痰饮咳嗽病"及"妇人产后病"等。《伤寒论》六经病均有下利,当辨证论治:太阳下利多为表邪内迫,阳明下利为热结旁流,少阳下利为胆热内迫,病情较轻,预后较好;三阴下利多正衰邪盛,病情较重,尤以少阴,厥阴严重,下利证在病入少阴厥阴之后由于人体阳气受到损伤,阴寒之邪滞留不去,正不胜邪,往往病情趋于危重之候,《金匮要略》之下利有明显的虚实寒热之别,通过条文解读仲景病位、病性、病势辨治思路,对指导临床辨证和选方用药有重要意义。
Diarrhea is a common syndrome in traditional Chinese medicine clinic. There are 84 articles on diarrhea in Shanghan Zabing Lun, and 42 articles(including compound articles) on diarrheain Jingui Yaolüe. The articles are widely distributed in the typhoid "six-menstrual disease" "cholera disease" "vomiting and sputum disease" "abdominal chills and stagnation disease" "sipping sputum cough disease" and "women's postpartum disease". The six meridian diseases in Shanghan Zabing Lun all involve diarrhea, which should be treated by differentiation of symptoms and signs. Diarrhea in Taiyang meridian is caused by exterior evil's entrance. Diarrhea in Yangming meridian is caused by bypass flow of heat junction. Diarrhea in Shaoyang meridian is caused by internal pressure of gallbladder heat, which is mild and the prognosis is good. Diarrhea, which occurs in three yin meridians, mostly manifests the pattern of healthy qi deficiency and pathogen excessiveness, and the condition is serious, especially in Shaoyin and Jueyin. After the disease enters Shaoyin and Jueyin, diarria syndrome often tends to be in critical condition because of the damage of yang qi, the yin and cold pathogen can not be detained, and the pathogen is invincible. There are obvious differences between deficiency, excess, cold and heat in Jingui Yaolüe. It is of great significance to guide clinical differentiation of symptoms and signs and to select prescriptions for clinical medication by interpreting Zhongjing's thinking of differentiation and treatment of disease location, disease nature and disease condition.
Diarrhea is a common syndrome in traditional Chinese medicine clinic. There are 84 articles on diarrhea in Shanghan Zabing Lun, and 42 articles(including compound articles) on diarrheain Jingui Yaolüe. The articles are widely distributed in the typhoid "six-menstrual disease" "cholera disease" "vomiting and sputum disease" "abdominal chills and stagnation disease" "sipping sputum cough disease" and "women's postpartum disease". The six meridian diseases in Shanghan Zabing Lun all involve diarrhea, which should be treated by differentiation of symptoms and signs. Diarrhea in Taiyang meridian is caused by exterior evil's entrance. Diarrhea in Yangming meridian is caused by bypass flow of heat junction. Diarrhea in Shaoyang meridian is caused by internal pressure of gallbladder heat, which is mild and the prognosis is good. Diarrhea, which occurs in three yin meridians, mostly manifests the pattern of healthy qi deficiency and pathogen excessiveness, and the condition is serious, especially in Shaoyin and Jueyin. After the disease enters Shaoyin and Jueyin, diarria syndrome often tends to be in critical condition because of the damage of yang qi, the yin and cold pathogen can not be detained, and the pathogen is invincible. There are obvious differences between deficiency, excess, cold and heat in Jingui Yaolüe. It is of great significance to guide clinical differentiation of symptoms and signs and to select prescriptions for clinical medication by interpreting Zhongjing's thinking of differentiation and treatment of disease location, disease nature and disease condition.
引文
[1]刘定承.《伤寒杂病论》下利证治规律探析[D].南京:南京中医药大学, 2016.
[2]何威华,吴显文.浅述《伤寒论》中六经下利[J].湖南中医杂志, 2013, 29(1):111-112.
[3]娄亮.《伤寒杂病论》下利与《中医内科学》泄泻辨治规律的比较研究[D].北京:北京中医药大学, 2017.
[4]陈海勇.《伤寒论》下利证探析[J].中医杂志, 2005, 4(46):104-105.
[5]安慧娟,白明贵.八纲辨证在《伤寒论》下利证应用[J].中医药临床杂志, 2017, 29(8):1172-1174.
[6]冯标婵.《伤寒论》对下利的辨治及其对后世的影响[D].广州:广州中医药大学, 2012.
[7]王廷富,著.王廷富金匮要略指难[M].王敬义,整理.北京:中国中医药出版社, 2016(11):368.
[8]张忠其.《伤寒论》下利的病机、治法及临床意义[J].国医论坛, 1994, 14(3):6-8.
[9]刘定承.《伤寒杂病论》下利证治规律探析[D].南京:南京中医药大学, 2016.
[10]韩美仙,傅延龄.名医类案三部中葛根在下利证中的应用[J].吉林中医药, 2010, 30(7):624-625.
[11]何新慧.《伤寒论》虚寒下利方学用心悟[J].环球中医药,2017, 10(5):558-559.
[12]何威华,吴显文.《伤寒论》中“下利”病因及治法探析[J].安徽中医学院学报, 2012, 31(6):1-2.
[13]王旭丽.《伤寒论》下利诊治规律探析[J].辽宁中医药大学学报, 2010, 12(8):73-75.
[2]何威华,吴显文.浅述《伤寒论》中六经下利[J].湖南中医杂志, 2013, 29(1):111-112.
[3]娄亮.《伤寒杂病论》下利与《中医内科学》泄泻辨治规律的比较研究[D].北京:北京中医药大学, 2017.
[4]陈海勇.《伤寒论》下利证探析[J].中医杂志, 2005, 4(46):104-105.
[5]安慧娟,白明贵.八纲辨证在《伤寒论》下利证应用[J].中医药临床杂志, 2017, 29(8):1172-1174.
[6]冯标婵.《伤寒论》对下利的辨治及其对后世的影响[D].广州:广州中医药大学, 2012.
[7]王廷富,著.王廷富金匮要略指难[M].王敬义,整理.北京:中国中医药出版社, 2016(11):368.
[8]张忠其.《伤寒论》下利的病机、治法及临床意义[J].国医论坛, 1994, 14(3):6-8.
[9]刘定承.《伤寒杂病论》下利证治规律探析[D].南京:南京中医药大学, 2016.
[10]韩美仙,傅延龄.名医类案三部中葛根在下利证中的应用[J].吉林中医药, 2010, 30(7):624-625.
[11]何新慧.《伤寒论》虚寒下利方学用心悟[J].环球中医药,2017, 10(5):558-559.
[12]何威华,吴显文.《伤寒论》中“下利”病因及治法探析[J].安徽中医学院学报, 2012, 31(6):1-2.
[13]王旭丽.《伤寒论》下利诊治规律探析[J].辽宁中医药大学学报, 2010, 12(8):73-75.