浅析《伤寒论》太阳病篇误汗变证
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摘要
张仲景在《伤寒论》太阳病篇中论述了大量运用汗法治疗疾病的条文,其中既有正确运用汗法者,也不乏大量误用汗法而产生变证者。《伤寒论》中太阳病误汗所致变证的病机有:汗出不彻致变,伤阴阳气血,伤胃中津液,伤脏腑阳气,正虚邪入。汗法不当既可伤阳,又可伤阴,更可阴阳两伤,既可伤在表之阳气,又可伤在内之津液和脏腑之气。虽然同为误汗变证,其病情程度和病变所在部位却迥然不同。不同变证成因主要有:发汗汗出程度不同,邪气留去不同,患者体质和脏腑气血盛衰不同,脏腑的生理特点和相互间的联系不同。张仲景对于不同变证的治法用药不同,但本质上仍然秉承救阳气和护脾胃的原则。
Zhang Zhong-jing discusses the articles on the treatment of diseases by sweating in Taiyang disease chapter of Treatise on Cold Damage Diseases. Among them,there is not only correct use of sweating method,but also a large number of misuse of sweating method causing deteriorated syndrome. In Treatise on Cold Damage Diseases,the pathogeneses of deteriorated syndrome caused by misuse of sweating of Taiyang disease are as follows: incomplete sweating,damaging yin and yang and qi and blood,damaging body fluid in stomach,damaging viscera yang qi,deficient healthy qi and pathogenic factor entering the body. The deteriorated syndromes caused by improper sweating method are complex and varied. Its pathogenesis can injure not only yang,but also yin,and both yang and yin. It can injure not only yang in the surface,but also body fluid and viscera qi in the internal organs. Although they are the same deteriorated syndrome due to misuse of sweating,the degree of the disease and the location of the lesion are quite different. The main causes of different syndromes are as follows: different sweating degree,different retention of pathogenic qi,different constitution of patients and the ups and downs of zang-fu qi and blood,physiological characteristics of zang-fu organs and their relationship. Zhang Zhong-jing has different therapies and medications,but in essence he still adheres to the principles of saving yang qi and protecting the spleen and stomach.
Zhang Zhong-jing discusses the articles on the treatment of diseases by sweating in Taiyang disease chapter of Treatise on Cold Damage Diseases. Among them,there is not only correct use of sweating method,but also a large number of misuse of sweating method causing deteriorated syndrome. In Treatise on Cold Damage Diseases,the pathogeneses of deteriorated syndrome caused by misuse of sweating of Taiyang disease are as follows: incomplete sweating,damaging yin and yang and qi and blood,damaging body fluid in stomach,damaging viscera yang qi,deficient healthy qi and pathogenic factor entering the body. The deteriorated syndromes caused by improper sweating method are complex and varied. Its pathogenesis can injure not only yang,but also yin,and both yang and yin. It can injure not only yang in the surface,but also body fluid and viscera qi in the internal organs. Although they are the same deteriorated syndrome due to misuse of sweating,the degree of the disease and the location of the lesion are quite different. The main causes of different syndromes are as follows: different sweating degree,different retention of pathogenic qi,different constitution of patients and the ups and downs of zang-fu qi and blood,physiological characteristics of zang-fu organs and their relationship. Zhang Zhong-jing has different therapies and medications,but in essence he still adheres to the principles of saving yang qi and protecting the spleen and stomach.
引文
[1]张仲景.伤寒论[M].北京:人民卫生出版社,2005:26,28,39,70.
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[3]黄帝内经·素问[M].北京:人民卫生出版社,2005:45.
[4]李振华,尹潇爽.“营卫不和”与“太阳病”———读《伤寒杂病论》[J].中华中医药杂志,2018,33(6):2551-2552.
[5]灵枢经[M].北京:人民卫生出版社,2005:53.
[6]扁鹊.黄帝八十一难经[M].北京:学苑出版社,2007:70.
[7]周作文,王彩霞.脾气探微[J].实用中医内科杂志,2015,29(4):10-12.
[8]张晋升.张仲景治疗心悸的方证辨治探析[J].辽宁中医药大学学报,2015,17(12):112-114.
[9]吴静珠,陈宁勇,史喜苗.论《伤寒论》中汗法伤阳[J].长春中医药大学学报,2015,31(1):3-5.
[10]程偲婧,沈宏春,徐颖,等.小议《伤寒论》之汗法[J].亚太传统医药,2017,13(1):70-71.
[11]谭可欣,蒋志诚.“观其脉证,知犯何逆,随证治之”的临床应用[J].中医药导报,2017,23(9):46-48.
[12]吴塘.温病条辨[M].北京:人民卫生出版社,2005:165.
[13]余天泰.《伤寒论》扶阳思想探讨[J].中医药通报,2013,12(4):12-15.
[14]黄晓芬,张婷.《伤寒论》护阴液思想[J].中医药导报,2018,24(7):13-15.
[15]熊寿试.伤寒论集注[M].北京:中国中医药出版社,2015:12.
[2]陈明.《伤寒论》太阳病误汗原因分析[C].北京:2013医圣仲景南阳国际论坛暨海峡两岸中医药与太极养生文化研讨会论文集,2013:32-33.
[3]黄帝内经·素问[M].北京:人民卫生出版社,2005:45.
[4]李振华,尹潇爽.“营卫不和”与“太阳病”———读《伤寒杂病论》[J].中华中医药杂志,2018,33(6):2551-2552.
[5]灵枢经[M].北京:人民卫生出版社,2005:53.
[6]扁鹊.黄帝八十一难经[M].北京:学苑出版社,2007:70.
[7]周作文,王彩霞.脾气探微[J].实用中医内科杂志,2015,29(4):10-12.
[8]张晋升.张仲景治疗心悸的方证辨治探析[J].辽宁中医药大学学报,2015,17(12):112-114.
[9]吴静珠,陈宁勇,史喜苗.论《伤寒论》中汗法伤阳[J].长春中医药大学学报,2015,31(1):3-5.
[10]程偲婧,沈宏春,徐颖,等.小议《伤寒论》之汗法[J].亚太传统医药,2017,13(1):70-71.
[11]谭可欣,蒋志诚.“观其脉证,知犯何逆,随证治之”的临床应用[J].中医药导报,2017,23(9):46-48.
[12]吴塘.温病条辨[M].北京:人民卫生出版社,2005:165.
[13]余天泰.《伤寒论》扶阳思想探讨[J].中医药通报,2013,12(4):12-15.
[14]黄晓芬,张婷.《伤寒论》护阴液思想[J].中医药导报,2018,24(7):13-15.
[15]熊寿试.伤寒论集注[M].北京:中国中医药出版社,2015:12.