张仲景论“痞”释义并“类似证”举隅  

Meaning of “Pi” Proposed by ZHANG Zhongjing and Examples of “Similar Syndrome”

作　　者：李心机[1] LI Xinji(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学

出　　处：《山东中医杂志》2018年第9期713-717,共5页Shandong Journal of Traditional Chinese Medicine

摘　　要：在张仲景《伤寒论》与《金匮要略》中,＂痞＂首先是一个症状,有时也是一个证候。作为症状,痞有三种形态：气痞、痞硬与痞块。此只是相比较而言,＂气痞＂的＂濡＂与＂痞硬＂的＂硬＂没有明确界限;＂痞硬＂的＂硬＂,与＂痞块＂的＂块＂也无明确界限。痞＂硬＂到一定的程度,可发展成为＂痞块＂。痞,是＂证＂,还是＂症＂,这在张仲景书中是不确定的。痞可以属寒、热、虚、实,属寒热错杂,属虚实相兼等,从而可以形成多个不同的证。同时,这些证在一定的条件下,还可能互相转化。在张仲景书中,痞证不只是五泻心汤证,而把五泻心汤证之外的痞称为＂痞的类似证＂是对张仲景论痞的谬解。In Treatise on Cold Damage and Essentials from the Golden Cabinet by ZHANG Zhongjing,firstly,pi is a symptom,but sometimes it also is a syndrome. As a symptom,there are three forms,qi-pi,pi-hardness,and pi-lump. In comparison,there is no obvious difference between the softness of ＂qi-pi＂ and the＂hardness＂ in the ＂pi-hardness＂,and so is the difference between the hardness of pi-hardness and lump of pilump. Under certain circumstances,the hardness can become a lump. Whether ＂pi＂ is a ＂syndrome＂ or ＂symptom＂,is not defined by ZHANG Zhongjing. Pi can be cold or hot,deficient or excessive,and also it belongs to the mixture of cold and heat,or mixture of deficiency and excess. Hence it can form various syndrome. Besides,these syndrome may transform into each other under certain conditions. In the works by ZHANG Zhongjiang,pi syndrome refers to more than 5 syndromes of Xiexing Decoction,and therefore it is a false understanding of ZHANG Zhongjing＇s pi to name ＂pi＂ not from syndrome of 5 Xiexing Decoction as＂similar syndromes of pi＂.

关 键 词：张仲景 痞 痞证 症状 气痞 痞硬 痞块 

分 类 号：R222[医药卫生—中医基础理论]