基于“常变观”谈《伤寒论》表里同病之辨治
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摘要
将《伤寒论》中表证与里证同在的条文与相应治疗方法进行梳理,基于"常变观"归纳总结《伤寒论》中表里同病的治法。认为仲景针对表里同病的证候,通过判断疾病的标本、轻重缓急、病位、疾病传变等因素而分别采用表里同治、和解表里、先解表后治里、先治里后解表、只解表、只治里6种治法,体现了仲景在诊疗时注重辨证、灵活多变的治疗方法与处方思路,进一步说明了"常变观"在学习《伤寒论》中的重要性。
The article combines the provisions of the superficies and interior syndromes of Shanghan Lun and the corresponding treatment methods, and summarizes the treatment methods of simultaneous superficies and interior syndromes based on the view of "Changing View". Zhongjing used six methods to treat the disease by judging their symptoms, priorities, locations, disease transmissions and so on. They were regulating the exterior and interior syndrome diseases, treating exterior syndrome first, treating interior syndrome first, only treating exterior syndrome and only treating interior syndrome. These six methods embody Zhongjing's emphasis on syndrome dif ferentiation and flexible treatment methods and prescription ideas in diagnosis and treatment, and further illustrate the importance of "Changing View" in Shanhan Lun.
The article combines the provisions of the superficies and interior syndromes of Shanghan Lun and the corresponding treatment methods, and summarizes the treatment methods of simultaneous superficies and interior syndromes based on the view of "Changing View". Zhongjing used six methods to treat the disease by judging their symptoms, priorities, locations, disease transmissions and so on. They were regulating the exterior and interior syndrome diseases, treating exterior syndrome first, treating interior syndrome first, only treating exterior syndrome and only treating interior syndrome. These six methods embody Zhongjing's emphasis on syndrome dif ferentiation and flexible treatment methods and prescription ideas in diagnosis and treatment, and further illustrate the importance of "Changing View" in Shanhan Lun.
引文
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[2]张楠,董正华.试论《伤寒论》中的常变观[J].国医论坛,2005, 20(5):1-2.
[3]姜良铎.姜良铎医案选[M].北京:中国中医药出版社,2011:13-14.
[4]丹波元坚.伤寒广要[M].北京:学苑出版社, 2009:11.
[5]郑鑫,王志英.表里双解法治疗病毒性外感热病[J].吉林中医药, 2015, 35(2):124-127.
[6]姜建国.伤寒论[M].北京:中国中医药科技出版社, 2004:62-109.
[7]鲍艳举,花宝金.浅议《伤寒论》表里同病诊治之先后[J].国医论坛, 2007, 22(2):4-5.
[8]刘渡舟.刘渡舟《伤寒论》讲稿[M].北京:人民卫生出版社,2008:91.
[9]张永宜,赵天才.张仲景治疗表里同病的5种方法[J].国医论坛, 2012, 27(2):7-8.
[10]李文龙,滕久祥.仲景表里同病辨治规律微探[J].时珍国医国药, 2009, 20(9):2345-2346.
[11]柯琴.伤寒来苏集[M].北京:中国医药科技出版社,2011.
[12]张国骏.成无己医学全书[M].北京:中国中医药出版社,2004:88.
[13]胡爱萍.浅谈《伤寒论》表里同病的用药原则[J].光明中医,2006, 21(3):23-25.
[14]刘鹏.医义溯源:中医典籍与文化新探[M].北京:中国医药科技出版社, 2017:47.
[15]肖相如.肖相如论伤寒[M].北京:中国中医药出版社,2009:150.