《金匮要略》论湿之病脉证治研究
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摘要
目的通过对仲景《金匮要略》论湿之病脉证治的研究,从病、脉、证、治的角度探讨仲景论湿的规律,归纳仲景论湿的特点,从而助益临床湿病的辨治。同时,以期由湿为切入口,增加对仲景理论的研究角度和研究方法,为其他病因病邪致病的病脉证治研究奠定基础。
     方法从概念入手明确“湿”、“湿气”、“湿邪”、“湿病”等的含义,进而分篇分条缕析《金匮要略》中与湿有关的篇章和条文,并从病、脉、证、治的角度分别进行分析,找出各自的规律,最后在此基础上体会并归纳总结原著论湿的特点。
     结果①《金匮要略》论湿之病,重视湿病的诊断与鉴别、判断湿病的转归与预后、注意湿病的转化与演变。②《金匮要略》论湿之脉,较舌详细,有主脉、可见脉、相兼脉、成因脉、补充脉。③《金匮要略》论湿之证,通过识症以辨病,而辨证以辨病为前提,辨同病之异证、兼证及坏证,并对兼症、或然症进行随症加减。④《金匮要略》论湿之治,内治法和外治法灵活丰富,从“汗”、“便”见治效,由“二禁一慎”明治禁。⑤《金匮要略》论湿的特点,辨病证症结合论治、谨守脏腑经络辨证、创湿病治法与方剂。
     结论《金匮要略》论湿并不囿于湿痹,论湿之病脉证治着实有助临床,实开湿病体系之先河。追随仲景思维,论湿之病脉证治,为其他病因病邪致病的病脉证治研究奠定基础。
Objective Discuss the rule and feature about dampness in Jin Kui Yao Lve written by Zhang Zhongjing, from the aspects of diseases, pulses, symptoms, syndromes and treatments, in order to benefit the diagnosis and treatment in clinical diseases caused by dampness. As an entry point, increase views of research and study methods about Zhang Zhongjing's theory and lay the foundation of research on other pathogenesis and pathogenic factors in the same way.
     Methods Clear and definite the concepts about dampness, dampness-qi, evil dampness, diseases caused by dampness, etc.. Then sort out chapters, sections and items about dampness in Jin Kui Yao Lve, analyze and find out the rule respectively from the aspects of diseases, pulses, symptoms, syndromes and treatments. On this basis, understand and summarize the feature about dampness in the original.
     Results①When Jin Kui Yao Lve discusses diseases caused by dampness, it pays attention to diagnosis and differential diagnosis, estimates clinical outcome and prognosis, notices conversion and evolution in diseases as well.②When Jin Kui Yao Lve discusses pulses about dampness, it describes the pulses more than the tongues, including main pulses, visible pulses, subordinate pulses, etiogenic pulses and supplement pulses in detail.③When Jin Kui Yao Lve discusses symptoms and syndromes, it differentiates diseases by recognizing the symptoms, then differentiates syndromes, including different syndromes, subordinate syndromes and bad syndromes, and add or subtract the herb according subordinate symptoms and probable symptoms.④When Jin Kui Yao Lve discusses treatments, its internal therapy and external therapy are flexible and plentiful, including cure changes in sweat, excrement or urine and therapy prohibitions.⑤Jin Kui Yao Lve combines diseases, syptoms and syndromes together for diagnosis and treatment, takes syndrome differentiation of viscera and meridians as law and creates therapeutic methods and prescriptions for diseases caused by dampness.
     Conclusion Dampness discussed in Jin Kui Yao Lve is not limited by dampness-obstruction, but creates a precedent in the system of diseases caused by dampness. Following the thought of Zhang Zhongjing, study diseases, pulses, symptoms, syndromes and treatments about dampness, as well as lay the foundation of research on other pathogenesis and pathogenic factors in the same way.
引文
1.黄英志.叶天士医学全书.北京:中国中医药出版社,2012:342
    2.李连成,刘秉昭.湿病源流.中国医药学报,2001,16(5):5-9
    3.蒋明.论以辨病为前提之《金匮要略》病证结合模式.南京中医药大学学报,2003,19(2):65-68
    4.张机.伤寒论.上海中医学院伤寒温病学教研组,校注.上海:上海科学技术出版社,1983
    5.刘力红.思考中医.桂林:广西师范大学出版社,2008:229-230
    6.张秀美,王秀莲.浅析中医之湿.天津中医药,2011,28(2):171-172
    7.赵献可.医贯.郭君双,整理.北京:人民卫生出版社,2005:128
    8.徐成贺.《金匮》“五邪”考.四川中医,1992,(7):3-4
    9.吴谦.御纂医宗金鉴.太原:山西科学技术出版社,2011:185
    10.王建新,李芳.对湿邪属性的分析补充.安徽中医学院学报,1994,13(2):9-10
    11.虞抟.医学正传.北京:人民卫生出版社,1965:74
    12.严余明.《金匮要略》湿病表里分治之我见.浙江中医学院学报,1997,21(4):5
    13.魏雪舫,陈忠琳.桂林古本《伤寒杂病论》研究述评.国医论坛,1997,12(2):1-4
    14.范永升.金匮要略.中国中医药出版社,2003:3
    15.张清苓,姜元安,李致重.论中医辨证方法及辨证论治体系.北京中医药大学学报,2002,25(4):5-9
    16.赵心华,鲍计章,周国琪.回顾十年来对秦汉时期辨证方法的研究.中医文献杂志,2009,27(1):53-56
    17.尤怡.金匮要略心典.李占永,岳雪莲,点校.北京:中国中医药出版社,1992
    18.刘会琴,李昭,吉贤.《金匮要略》湿痹历节病辨治探讨.全国第二十次仲景学说学术年会论文集.2012:75-77
    19.王子接.绛雪园古方选注.北京:中国中医药出版社,1993
    20.戴起宗.脉诀刊误.上海:上海科学技术出版社,1958:33
    21.李中梓.诊家正眼.包来发,校注.北京:中国中医药出版社,2008
    22.王洪图,杨凤珍,贺娟,等.难经白话解.北京:人民卫生出版社,2004
    23.沈明宗.伤寒六经辨证治法.太原:山西科学技术出版社,2011:5
    24.黄宫绣.脉理求真.北京:人民卫生出版社,1959
    25.刘永年,潘文奎.张仲景有关大脉论述之浅析.广西中医药,1983,6(6):10-13
    26.张璐.诊宗三昧.张成博,欧阳兵,点校.天津:天津科学技术出版社.1999:26
    27.李玉清.滑寿医学全书.北京:中国中医药出版社,2006
    28.王付.伤寒杂病论字词句大辞典.北京:学苑出版社,2005:429-430
    29.钱潢.伤寒溯源集.上海:上海卫生出版社,1957
    30.孟景春,王新华.黄帝内经灵枢译释.上海:上海科学技术出版社,2011:462
    31.黄元御.黄元御医学全书.孙洽熙,主编.太原:山西科学技术出版社,2010
    32.高学山.高注金匮要略.上海:上海卫生出版社,1956:260
    33.管玉衡.珍本医书集成.上海:上海科学技术出版社,1985:6
    34.李延是.脉诀汇辨.武国忠,点校.海口:海南出版社,2012:69
    35.李时珍.频湖脉学译注.程宝书,张艳秋,译注.北京:中国中医药出版社,2013:75
    36.王付,杨志强.《伤寒杂病论》病证症的辨证关系考辨.中医药学刊,2004,22(5):808-809
    37.朱文锋.论症证病结合治疗.辽宁中医杂志,2000,27(1):6-8
    38.童舜华,童瑶,段逸山.张仲景病证结合论治思想探析.江西中医药,2003,34(248):10-11
    39.李克光,张家礼.金匮要略译释.上海:上海科学技术出版社,2010:548
    40.李小嘉,张弢.谈《金匮要略》治湿十法.甘肃中医学院学报,2011,28(6):25-27
    41.徐忠可.金匮要略论注.邓明仲,张家礼,点校.北京:人民卫生出版社,1993:220
    42.宋乃光,李瑞,赵自强,等.温病八大名著.北京:中国中医药出版社,2005:772
    43.陈熠.喻嘉言医学全书.北京:中国中医药出版社,2011
    44.赵以德,周扬俊.金匮玉函经二注.周衡,王旭东,点校.北京:人民卫生出版社,1990:170
    45.李彦.从防己黄芪汤的组方配伍谈益气利水法[J].中国医药学报,2002,17(10):587-589
    46.赵以德.金匮方论衍义.刘恩顺,王玉兴,王洪武,校注.北京:中医古籍出版社,2012:218
    47.张璐.张氏医通.孙玉信,王晓田,点校.上海:第二军医大学出版社,2006
    48.林惠光.中医九大经典.北京:中国中医药出版社,2012:442
    49.汪昂.本草备要.陈赞育,点校.沈阳:辽宁科学技术出版社,1997:5
    50.黄仰模,陈志勇,章文平,等.《金匮要略》治风湿病方剂探要.中华中医药学刊,2008,26(3):471
    51.高树中,许法同.中医熏洗疗法史略.中医外治杂志,1997,6(6):3-5
    52.纪开东.论“瞑眩”.南京中医学院学报,1989,(1):8一10
    53.张再良,程磐基.谈仲景的辨病与辨证.上海中医药大学学报,2002,16(3):6-8
    54.任应秋.谈谈中医的“辨证论治”.陕西新医药,1976,(1):35-39
    55.任应秋.略谈辨证与辨病.湖南中医学院学报,1979,(1):1-3
    56.叶天士.临证指南医案.苏礼,焦振廉,张琳叶,等整理.北京:人民卫生出版社,2006
    57.张志兰,杨万章.中医妇科外治法简史.中医外治杂志,1995,5(5):3-5
    58.田思胜.朱丹溪医学全书.北京:中国中医药出版社,2012:38
    59.张仲景.金匮要略.何任,何若苹,整理.北京:人民卫生出版社,2005
    60.南京中医学院医经教研组.黄帝内经素问译释.上海:上海科学技术出版社,1981
    61.福州市人民医院.脉经校释.北京:人民卫生出版社,1984
    1.王辉武.湿邪致病何其多.实用中医药杂志,2011,27(7):480-481
    2.黄英志.叶天士医学全书.北京:中国中医药出版社,2012:342
    3.路志正主编.中医湿病证治学.北京:科学出版社,2010:3
    4.李连成,刘秉昭.湿病源流.中国医药学报,2001,16(5):5-9
    5.黄振东.《金匮要略》关于湿病的治疗.湖北中医杂志,2002,24(12):20-21
    6.邹贤德.《金匮要略》“湿病”探微.河南中医,2006,26(4):1-3
    7.张辰.《金匮要略》表湿证治浅议.甘肃中医,2008,21(2):32
    8.马晓峰.论《金匮要略》湿病证治规律.辽宁中医杂志,1999,26(9):394-396
    9.张甦颖.《金匮要略》湿病相关问题的探讨.河南中医,2009,29(7):。625-626
    10.胡小勤,陈利国.《黄帝内经》对湿病的认识.时珍国医国药,2006,17(5):1321-1322
    11.徐重明,汪自源.《金匮要略》湿病证治举隅.河北中医,2001,23(1):64
    12.李小嘉,张弢.谈《金匮要略》治湿十法.甘肃中医学院学报,2011,28(6):25-27
    13.黄仰模,赵诗哲,刘丽娟,等.《金匮要略》风湿病治法探要.中医药学刊,2005,23(2):217-218
    14.王恒照,刘旺国,王艳,等.《金匮要略》湿证辨治研讨.甘肃中医学院学报,2001,18(4):1-4
    15.周长清.试述汗法在《金匮要略》湿病治疗中的运用.实用中医药杂志,2007,23(8):532-533
    16.支焱.《金匮要略》湿病探蕴.河南中医,2009,29(5):420-421
    17.邱新萍.浅谈《金匮要略》“通达阳气”法在痹证中的运用.北京中医药,2010,29(9):678-679
    18.王伟,巴建全.浅析燠土胜水法.四川中医,2012,30(6):36-37
    19.黄仰模,陈志勇,章文平,等.《金匮要略》治风湿病方剂探要.中华中医药学刊,2008,26(3):471-472
    20.朱秀华.《金匮要略》湿病述要.湖北中医杂志,2001,23(1):9
    21.陈大权,王立颖.《金匮要略》桂枝附子汤证与白术附子汤证鉴别之我见.天津中医学院学报,2004,23(2):59-60
    22.李宇铭,姜良铎.桂枝附子汤与甘草附子汤释义.山东中医药大学学报,2011,35(3): 210-212
    23.韩永刚,胡荫奇.《金匮要略》治湿方证及特点.江西中医药,2004,35(261):19-21
    24.蔡英剑,邱明友.《金匮要略》治湿探微.陕西中医,2003,24(3):280-282
    25.米小红,张甦颖.《金匮要略》白术用法探讨.山东中医药大学学报,2010,34(4):318-319
    26.蔡秋杰,曹洪欣.张仲景运用附子浅析.中医药信息,2006,23(2):22-23
    27.袁建.从《金匮要略》方后注浅探仲景治疗湿病的思路.湖北中医杂志,2009,31(2):29-30
    28.唐雪春,试述《金匮要略》论湿病的特点与不足.云南中医学院学报,2002,25(3):38-39
    29.林兴栋,刘叶,王占方.《金匮要略》湿证及《湿热条辨》湿热证辨析.新中医,2012,44(5):155-156

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