《伤寒杂病论》小便不利源流考及其证治规律研究
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摘要
本文重点探讨了癃闭、小便不利和淋闭的概念及其沿革,探讨了张仲景《伤寒杂病论》对小便不利的证治规律,提出:1.风寒外袭,气化不行,治以祛风解表,化气行水;2.邪入少阳,三焦不利,治以和解少阳,疏利三焦;3.肺气不宣,通调失职,治以宣通肺气,利尿消肿;4.湿热内郁,水不畅行,治以清热除湿,利尿行水;5.脾失健运,水气不行,治以健脾益气,温阳利水;6.肝气郁滞,水湿不化,治以疏肝理气,通利三焦;7.肾气虚衰,气化失职,治以补益肾气,化气行水;8.瘀热内阻,小便不利,治以清热化瘀,通利小便;9.津液受损,化源不足,治以顾护津液,化通小便。研究归纳出其治疗特点:1.祛除邪气,疏利气机;2.利水祛邪,当随其所得;3.扶助正气,恢复脏腑气化功能;4.治水不忘治气治血。对现代临床小便不利的辨证论治具有重要指导意义。
This article centres on the concept and evolution of dysuria、difficulty in urination andlin bi, and the syndrome and therapeutic principles of the difficulty in urination inShanghan Zabing Lun are also main enquiry in this essay. Propose:1.Affection byexopathogenic cold-wind, disturbance in qi activity, treated with dispelling wind to relieveexogenous syndrome, gas lines of water;2.Pathogenic factor into Shaoyang, tripleenergizer disadvantageous, treated with reconciliation Shaoyang, sparsely Lee tripleburner;3.Obstruction of the lung-qi, dereliction of duty on the part of the pass notes,treated with ventilating lung-qi, diuresis to reduce edema;4. Interior retention of damp heatpathogen, water-poor line hot and humid, treated with removing damp-heat, diuretic waterline;5. Dysfunction of the spleen in transport, water vapor can not, treated withstrengthening spleen and replenishing qi, warming yang and promoting diuresis;6.Liver qistagnation, the moisture is not; treated with relieving the depressed liver qi, sparsely Leetriple burner;7.The asthenia of renal qi, gasification dereliction, treated withKidney-Nourishing and Qi-Enriching in order to benefit kidney water, gas lines;8.StagnantHeat resistance, urination, governance in order to heat circulation, Tom Lee urine;9.Bodyfluid damage of the source, treated with body fluid to nursing care of through urine.Thestudy concludes the treatment characteristics:1.Get rid of the pathogenic factor,regulating Qi;2.The diuresis Quxie when with the proceeds;3. Strengthening bodyresistance, to recovery organs gasification;4.Treating flood while curing gas Governanceblood. Urination modern clinical diagnosis and treatment of important guiding significance.
引文
[1]马继兴.马王堆医术考释[M].湖南:湖南科学技术出版社,1992,1:31.
    [2]夏庆,刘士敬.从出土秦汉医籍看中医治疗癃淋证[J].福建中医药,1986,29(3):13—14.
    [3]黄帝内经素问[M].北京:人民卫生出版社影印,1956:152.
    [4]黄帝内经素问[M].北京:人民卫生出版社影印,1956:54.
    [5]黄帝内经素问[M].北京:人民卫生出版社影印,1956:129.
    [6]灵枢经[M].北京:人民卫生出版社,1963:7.
    [7]黄帝内经素问[M].北京:人民卫生出版社影印,1956:78.
    [8]黄帝内经素问[M].北京:人民卫生出版社影印,1956:88.
    [9]灵枢经[M].北京:人民卫生出版社,1963:38.
    [10]灵枢经[M].北京:人民卫生出版社,1963:12.
    [11]灵枢经[M].北京:人民卫生出版社,1963:104.
    [12]叶霖.难经正义[M].上海:上海科学技术出版社,1981.28.
    [13]谭春雨.中藏经[M].学苑出版社,2007.28.
    [14]福州人民医院.脉经校释[M].北京:人民卫生出版社,1984:332.
    [15]福州人民医院.脉经校释[M].北京:人民卫生出版社,1984:20.
    [16]葛洪.肘后备急方[M]:北京:人民卫生出版社,1956:68.
    [17]巢元方.诸病源候论[M].北京:人民卫生出版社,1955.
    [18]孙思邈.千金要方[M].北京:人民卫生出版社,1952.
    [19]王焘.外台秘要[M].北京:人民卫生出版社,1955:741.
    [20]王焘.外台秘要[M].北京:人民卫生出版社,1955:743.
    [21]王焘.外台秘要[M].北京:人民卫生出版社,1955:647.
    [22]陈无择.三因极一病证方论[M].北京:人民卫生出版社,1957:165.
    [23]宋·太平惠民和剂局方[M].北京:人民卫生出版社,1985.
    [24]严用和.医学全书[M].北京:中国中医药出版社,2006.69
    [25]沈括,苏轼.苏沈内翰良方[M].北京:中医古籍出版社,2009.193
    [26]朱丹溪.丹溪心法[M].北京:人民卫生出版社,2005:144.
    [27]李杲.兰室秘藏[M].北京:人民卫生出版社,1957:66.
    [28]罗天益.卫生宝鉴[M].北京:中国中医药出版社,2007.
    [29]张景岳.景岳全书[M].北京:人民卫生出版社,1955.579
    [30]王肯堂.证治准绳[M].北京:人民卫生出版社,1967:66.
    [31]李中梓.医宗必读[M].上海:上海科学技术出版社,1996:142.
    [32]秦景明.症因脉治[M].北京:中国中医药出版社,1998.
    [33]明·刘纯撰.伤寒治例[M].齐鲁书社,1995.
    [34]明·龚延贤.万病回春[M].北京:人民卫生出版社,1984.
    [35]明·李中梓.伤寒括要[M].北京:人民卫生出版社,2006.
    [36]明·李中梓.医宗必读[M].北京:人民卫生出版社,1995.
    [37]虞抟.医学正传[M].北京:人民卫生出版社,1965.289
    [38]李用粹.证治汇补[M].新疆:科技卫生出版社,1958:448.
    [39]吴谦.医宗金鉴杂病心法要诀白话解[M].北京:人民卫生出版社,1964.193
    [40]谢映庐.谢映庐医案[M].上海:上海科学技术出版社,2010:58.
    [41]清·郑寿全.医法圆通[M].北京:人民卫生出版社,2004.
    [42]清·沈金鳌.伤寒论纲目[M].上海:上海科学技术出版社,2007.
    [43]清·程国彭.医学心悟[M].北京:人民卫生出版社,1987.
    [44]清·秦之桢.伤寒大白[M].北京:人民卫生出版社,2006.
    [45]清·吴坤安.伤寒指掌[M].北京:人民卫生出版社,2002.
    [46]清·张璐.张氏医通[M].上海:上海科学技术出版社,1963.
    [47]清·张璐.张氏医通[M].上海:上海科学技术出版社,1963.
    [48]清·郑钦安.伤寒恒论[M].北京:人民卫生出版社,2006.
    [49]清·张锡纯.医学衷中参西录[M].河北科学技术出版社,1985.
    [50]清·张锡纯.医学衷中参西录[M].河北科学技术出版社,1985.
    [51]清·张璐撰.伤寒绪论[M].上海:上海卫生出版社,2001.
    [52]清·黄元御.金匮悬解[M].北京:人民卫生出版社,1998.
    [53]清·黄元御.伤寒说意[M].江左书林,2007.
    [54]林佩琴.类证治裁[M].上海:上海科学技术出版社,1996:42.
    [55]方药中等主编.实用中医内科学[M].上海:上海科学技术出版社,1986.288.
    [56]杜志中.《伤寒论》小便不利辨析[J].环球中医药.2008,1(5):21.
    [57]方药中等主编.实用中医内科学[M].上海:上海科学技术出版社,1986.287.
    [58]周仲瑛主编.中医内科学[M].北京:中国中医药出版,2003.370~372.
    [59]中山医学院.内科疾病鉴别诊断学[M].北京:人民卫生出版社,1975:572.
    [60]吴在德主编.外科学[M].北京:人民卫生出版社,1984:751.
    [61]李小会.《伤寒论》小便不利辨治分析及临床研究[J].辽宁中医杂志,2009:2112.
    [62]吕永赟.黄煌教授运用五苓散的经验[J].河北中医,2008,30(3):229-231.
    [63]朱海峰,朱同宜,朱冬霞.五苓散的双向调节作用[J].时珍国医国药,1998,9(6):542.
    [64]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.71.
    [65]刘献琳编.金匮要略语释[M].济南:山东科技出版社,1981.33.
    [66]李春艳.《伤寒论》中“小便利否”的临床意义及护理学价值[J].西部中医药,2011,10(24):85.
    [67]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.217.
    [68]吕志杰.仲景方药古今应用[M].北京:中医古籍出版社,2000.562
    [69]冯世纶.慢性肾炎如何辨治[J].中国医药学报,2004,19(6):357一358.
    [70]高木嘉子(王威译).柴胡桂枝干姜汤的治验例[J].日本医学介绍,1995,16(3):141.
    [71]李克光主编.金匮要略讲义[M].上海:上海科学技术出版社,1985.162.
    [72]方约生.牡蛎泽泻散加减治疗慢性肾炎蛋白尿53例[J].浙江中医杂志,1999,34(6):236.
    [73]刘静.牡蛎泽泻散临床新用[J].中华临床新医学,2005,5(9):801.
    [74]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.191.
    [75]陈明.《伤寒论》“小便异常”辨析及临床实践[J].中国医药学报,2002,11(17):663.
    [76]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.269.
    [77]吕新愿.金匮肾气丸的临床应用[J].陕西中医,2012,6(33):744.
    [78]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.256.
    [79]吕志杰.仲景方药古今应用[M].北京:中医古籍出版社,2000.595.
    [80]李克光主编.金匮要略讲义[M].上海:上海科学技术出版社,1985.155.
    [81]李克光主编.金匮要略讲义[M].上海:上海科学技术出版社,1985.255.
    [82]范永升主编.金匮要略[M].北京:中国中医药出版社,2009.198.
    [83]杨增昌,毛兴兵.《伤寒论》“小便不利”辨析[J].实用中医内科杂志,2011,10(25):18—19.
    [84]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.14.
    [85]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.267.
    [86]李克绍主编.伤寒论语释[M].济南:山东科技出版社,1982.92.
    [87]周学海.读医随笔[M].江苏:科学技术出版社,1983:185.
    [88]王付.《伤寒杂病论》辨小便不利的临床意义[J].中国药通报,2006,3(5):16.
    [89]范永升主编.金匮要略[M].北京:中国中医药出版社,2009.206.
    [90]李克光主编.金匮要略讲义[M].上海:上海科学技术出版社,1985.177.
    [91]范永升主编.金匮要略[M].北京:中国中医药出版社,2009.297.
    [92]赵波.加味猪苓汤治疗反复发作性泌尿感染64例[J].陕西中医,2007,28(5):529—530.
    [93]王惠君,宋俊生.猪苓汤方证临床文献研究[J].湖南中医杂志,2008,24(1):84—86.
    [94]陶汉华.金匮要略研读心悟[M].北京:人民卫生出版社,2008.255.
    [95]刘兴隆,邓中甲,姜冬云.浅析仲景真武汤中芍药的作用[J].光明中医,2008,23(2):161-162.
    [96]谢鸣.方剂学[M].北京:人民卫生出版社,2002:391.
    [97]王敏.真武汤用白芍析疑[J].河南中医,2005,25(9):11.
    [98]车晓璐,刘凤斌.真武汤中芍药作用疑析[J].新中医,2011,43(12):134-135.
    [99]张瑞卿,郝印卿,闫润红.真武汤合苏葶丸治疗肺心病合并心衰的实验研究[J].山西中医学院学报,2005,6(1):21-23.
    [100]吕志杰.仲景方药古今应用[M].北京:人民卫生出版社,2000.666.
    [101]贾永鹤,钟菊莲.当归芍药散的临床应用[J].中医杂志,2007,45.