苓桂术甘汤“开玄府-气化三焦”治疗慢性心力衰竭的探讨
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摘要
三焦、玄府理论肇始于《黄帝内经》,滥觞于金元,详辨于明清,二者虽为异名,实为一体。随着古今医家对玄府理论的拓展、阐释,其意义不断被扩大,形成广义与狭义玄府之分。由狭义的"玄府"既"汗孔",发展到"玄府"为存在于一切组织器官中的细微孔隙,是气机升降出入之门户,津液输布流通之道路,是集中体现生命活动气化功能的场所。而这种概念及理论的延伸,将玄府与三焦的功能进一步联系在一起,使二者在功能及结构上形成一个有机的整体。慢性心力衰竭的中医发生发展机制与玄府、三焦功能失常密切相关。由此,笔者提出"开玄府-气化三焦"治疗慢性心力衰竭的治法,并通过中医经典名方苓桂术甘汤得以验证。
Theories of Sanjiao and Xuanfu originate from Huangdi Neijing, developed in Jin and Yuan dynasty,and matured in Ming and Qing dynasty. Sanjiao and Xuanfu are of the integrity but with two different names. With the further elaboration by physicians over the ages, Xuanfu has been expanded from referring to sweat pores to all of the fine pores over the body, which is the gateway of qi movements(ascending, descending, exiting and entering) and fluids distribution, and also the place of qi transformation(symbol of life, encompassing all the functional activities of qi in the body). The expansion makes Xuanfu more related to the function of Sanjiao and the two are of the organic integrity both in structure and function. Based on theories of Traditional Chinese medicine, chronic heart failure is close related to the dysfunction of Xuanfu and Sanjiao. Therefore,the author puts forward the therapeutic method by unblocking Xuanfu and regulating qi transformation of Sanjiao, and verified it by applying Linggui Zhugan Decoction.
Theories of Sanjiao and Xuanfu originate from Huangdi Neijing, developed in Jin and Yuan dynasty,and matured in Ming and Qing dynasty. Sanjiao and Xuanfu are of the integrity but with two different names. With the further elaboration by physicians over the ages, Xuanfu has been expanded from referring to sweat pores to all of the fine pores over the body, which is the gateway of qi movements(ascending, descending, exiting and entering) and fluids distribution, and also the place of qi transformation(symbol of life, encompassing all the functional activities of qi in the body). The expansion makes Xuanfu more related to the function of Sanjiao and the two are of the organic integrity both in structure and function. Based on theories of Traditional Chinese medicine, chronic heart failure is close related to the dysfunction of Xuanfu and Sanjiao. Therefore,the author puts forward the therapeutic method by unblocking Xuanfu and regulating qi transformation of Sanjiao, and verified it by applying Linggui Zhugan Decoction.
引文
[1]戴雁彦,张立山.心衰水饮证的三焦论治.中华中医药杂志,2016,29(6):1899-1901
[2]郑玲玲,杜武勋,丛紫东,等.从“脏腑-气液-玄府”管窥心衰之病机.辽宁中医杂志,2014,41(10):2088-2089
[2]郑玲玲,杜武勋,丛紫东,等.从“脏腑-气液-玄府”管窥心衰之病机.辽宁中医杂志,2014,41(10):2088-2089