《伤寒论》“无形邪热与有形实邪相结”治疗思路  

Analysis on the treatment of “Invisible hot evil and tangible real evil”

作　　者：马娇阳 阚湘苓[1] 

机构地区：[1]天津中医药大学,天津300193

出　　处：《吉林中医药》2018年第2期146-148,共3页Jilin Journal of Chinese Medicine

摘　　要：《伤寒论》中有36条原文谈及"无形邪热与有形实邪相结","有形实邪"在《伤寒论》中有水饮、痰湿、湿邪、瘀血和肠间糟粕5种。其相关病证的治疗主要依从"清法与下法结合、侧重下法"的治疗原则,根据有形实邪的性质和所在部位的情况,选择性采取逐水泻热、利水清热、利湿泻热、逐瘀泻热、通腑泻热等"下法"。用药重用苦寒泻下之品,尤擅用大黄,根据实邪性质与所在部位的情况,采用不同剂量:偏上者用6两、8两,偏于中下者,用量在2~4两之间;且灵活配伍,针对有形实邪的性质用药。充分体现张仲景对《黄帝内经》下法的继承和发展,值得探讨兹以指导临床。There are 36 original provisions about ＂invisible evil heat and tangible real evil＂ in Shanghan Lun. The ＂ tangible real evil＂ refers to water evil, phlegm, wet evil, blood stasis and intestinal dross in Shanghan Lun. The treatment of the relevant syndromes mainly follow the principle of ＂combining heat-clearing method with purgative method and focusing on purgative method＂. According to the nature of the tangible real evil, to choose water diarrhea heat, diuresis heat, dampness diarrhea heat, stasis diarrhea heat, Tongfu diarrhea heat and other ＂purgative method＂. Medication reuse bitter cold diarrhea under the goods, especially good at rhubarb, and according to the nature of tangible real evil and the location of the situation, using the different doses： partial with six or eight liang, biased in the middle of the next, the amount between two to four liang. And according to the nature of tangible real evil, neatly and pertinently use the Chinese herbal medicine. This fully embodies ZHANG Zhongjing on the Huangdi Neijing under the purgative method of inheritance and development, it is worth exploring to guide clinical practice.

关 键 词：《伤寒论》 无形热邪 有形实邪 下法 

分 类 号：R222[医药卫生—中医基础理论]