《伤寒论》便血证治规律
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摘要
张仲景在《伤寒论》中论便血,多指大便下血,但亦可为小便溺血,病机有"热结膀胱""瘀热在里""热在下焦""热入血室""日久瘀血",其病多因热而起,也有虚寒之便脓血,故便血不可以热概之。太阳阳明便血为下焦瘀热互结之蓄血证,其血热瘀结,结而不甚者,治以桃核承气汤活血化瘀,通下瘀热。若血热瘀结甚者,治当以抵当汤,并中病即止。少阴虚寒便脓血证系下焦虚寒,阳虚统摄无权,大肠滑脱而致下利便脓血,故用桃花汤温阳散寒,涩肠固脱治之。厥阴病热盛阴虚便脓血证,为阳热盛而阴血虚,势必热灼营血,血络灼伤,化腐成脓所致,以柏叶阿胶汤治之。
In Treatise on Cold Damage Diseases,Zhang Zhong-jing mainly talks about bloody stool,but in fact blood in urine should also be included.The pathogeneses include heat accumulation in bladder,stasis heat in the interior,heat accumulation in lower energizer,heat invading uterus,and long-time blood stasis.The disease is mostly caused by heat,and there are feces and pus blood due to deficient cold,so bloody stool can not be generalized resulting from heat.Taiyang-Yangming bloody stool is due to blood accumulation syndrome manifested as blood stasis and heat accumulation in lower energizer.For light syndrome,Peach Kernel Qi-Guiding Decoction can be used to promote blood circulation and resolve blood stasis are remove heat.For serious syndrome,Resistance Decoction can be used until the disease is improved.Purulent bloody stool with Shaoyin deficiency cold is due to deficiency cold in lower energizer,yang deficiency,leading to intestinal slippage,so Peach Blossom Decoction can be used to warm yang and disperse cold,astringe intestines and relieve collapse.Jueyin Purulent bloody stool is due to excessive heat and deficient yin blood leading to heat burning nutrient-blood and blood channel,so Donkey-Hide Gelatin Decoction plus Cacumen Cupressi can be used to treat it.
In Treatise on Cold Damage Diseases,Zhang Zhong-jing mainly talks about bloody stool,but in fact blood in urine should also be included.The pathogeneses include heat accumulation in bladder,stasis heat in the interior,heat accumulation in lower energizer,heat invading uterus,and long-time blood stasis.The disease is mostly caused by heat,and there are feces and pus blood due to deficient cold,so bloody stool can not be generalized resulting from heat.Taiyang-Yangming bloody stool is due to blood accumulation syndrome manifested as blood stasis and heat accumulation in lower energizer.For light syndrome,Peach Kernel Qi-Guiding Decoction can be used to promote blood circulation and resolve blood stasis are remove heat.For serious syndrome,Resistance Decoction can be used until the disease is improved.Purulent bloody stool with Shaoyin deficiency cold is due to deficiency cold in lower energizer,yang deficiency,leading to intestinal slippage,so Peach Blossom Decoction can be used to warm yang and disperse cold,astringe intestines and relieve collapse.Jueyin Purulent bloody stool is due to excessive heat and deficient yin blood leading to heat burning nutrient-blood and blood channel,so Donkey-Hide Gelatin Decoction plus Cacumen Cupressi can be used to treat it.
引文
[1] 张仲景.伤寒杂病论[M].桂林:广西人民出版社,1980:118.
[2] 于本性.内科诸血症针灸处方配穴原则及规律的研究[D].沈阳:辽宁中医学院,2005.
[3] 李祥农.简便廉验的放血疗法[J].中国民族民间医药,2011,20(15):90.
[4] 岳亚军.穴位贴敷简介[J].中国民间疗法,2014,22(8):21.
[5] 陈必诚.经络理论与多种针灸治疗法[C].新加坡:第十届亚细安中医药学术大会暨第三届亚洲针灸高层论坛论文集,2012:232-241.
[2] 于本性.内科诸血症针灸处方配穴原则及规律的研究[D].沈阳:辽宁中医学院,2005.
[3] 李祥农.简便廉验的放血疗法[J].中国民族民间医药,2011,20(15):90.
[4] 岳亚军.穴位贴敷简介[J].中国民间疗法,2014,22(8):21.
[5] 陈必诚.经络理论与多种针灸治疗法[C].新加坡:第十届亚细安中医药学术大会暨第三届亚洲针灸高层论坛论文集,2012:232-241.