试论《伤寒杂病论》中无形水饮的证治  

Syndrome and treatment of invisible water-fluid disorder in Shanghan Zabing Lun

作　　者：董艳[1] 姚魁武[1] 高嘉良[1] 姜文睿[1] 王阶[1] DONG Yan;YAO Kui-wu;GAO Jia-liang;JIANG Wen-rui;WANG Jie(Guang＇anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中华中医药杂志》2018年第5期1917-1920,共4页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：中医水饮大多认为与水肿,或水液停聚于身体局部所致的胸腔积液、尿潴留等相关,其常被视为可见、可闻或可触的有形之邪。但是,临床上笔者发现许多无明显水肿或积液表形的患者,仍然有水饮内停的其他指征,且运用化饮利水方药后疗效显著。故重温经典,反思张仲景水饮之治,发现水饮确有有形与无形之分。而无形水饮致病既可以显现出痰饮、支饮之动象,又可以表现为留饮、伏饮的静象。其病机关键在于水气交结,而临床论治可遵张仲景温阳化气利水之法,从肺脾肾三焦辨治。Water-fluid disorder was usually considered to be related to edema or hydrothorax and urinary retention caused by water retention in the body. It＇s therefore often seen as visible, audible or touchable pathogenic factor. However, many patients without obvious signs of edema or water retention still had other indicators of water-fluid disorder in clinical practice. In addition, when Chinese materia medica with the diuretic function was used, water-fluid disorder would be relieved. Hence, we reread and thought over the classics of ZHANG Zhong-jing, and found that both visible and invisible water-fluid disorder did exist in the meantime. The manifestations caused by invisible water-fluid disorder could show not only the dynamic of phlegm-fluid retention and thoracic fluid retention but also the static situation of prolonged fluid retention and latent fluid retention. Its critical pathogenesis was the interaction of liquid and qi. The therapy could comply with Zhong-jing＇s methods of warming yang and qi for diuresis from the perspective of regulating the function of lung, spleen, and kidney.

关 键 词：水饮 无形 水肿 积液 理论探究 

分 类 号：R222[医药卫生—中医基础理论]