《伤寒论》第73条之我见  

My Opinion on Article 73 of Shanghan Lun

作　　者：孟庆鸿 曾丽蓉[1] 李明峰 MENG Qinghong;ZENG Lirong;LI Mingfeng(Tianjin University of Chinese Medicine,Tianjin China 301617)

机构地区：[1]天津中医药大学

出　　处：《中医学报》2019年第11期2299-2302,共4页Acta Chinese Medicine

摘　　要：《伤寒论》第73条强调了鉴别诊断的意义,看似以"渴"与"不渴"的证候来鉴别五苓散证和茯苓甘草证,实则蕴含着中医辨证思维与临床鉴别诊断思维,从病位、证候、方药等多角度全方位地审视疾病。五苓散适用于有具体的脱水史,可明确诊断病位在三焦,证候并见上、下二焦证候的患者;茯苓甘草汤适用于素体胃阳虚弱,可明确诊断病位在中焦脾胃,证候未见上、下二焦证候的患者。当临床不能明确区分五苓散证与茯苓甘草汤证时,可先予五苓散以试探之,若"汗出"与"渴"同时出现,则选用五苓散;若不同时出现,或者出现"不渴"时,选取茯苓甘草汤。Article 73 of Shanghan Lun emphasizes the significance of differential diagnosis. It seems that the syndrome of " thirst" and " non-thirst" is used to differentiate Wuling Powder syndrome and Fuling Gancao Decoction syndrome. In fact,it contains the thinking of TCM syndrome differentiation and clinical differential diagnosis. It examines the disease from the aspects of location,syndromes,prescriptions and medicines in an all-round way. Wuling Powder is suitable for patients with specific history of dehydration,which can clearly diagnose the location of the disease in sanjiao,with the syndromes of upper and lower jiao. Fuling Gancao Decoction is suitable for patients with weakness of stomach yang,which can clearly diagnose the location of the disease in the spleen and stomach of mid-Jiao,without the syndromes of upper and lower Jiao. When there is no clear distinction between Wuling Powder syndrome and Fuling Gancao Decoction syndrome in clinical practice,Wuling Powder can be given as a trial. If " sweating" and " thirst" occur at the same time,Wuling Powder is chosen;if not at the same time,or when " not thirsty",Fuling Gancao Decoction syndrome is selected.

关 键 词：《伤寒论》第73条 五苓散证 茯苓甘草汤证 方证鉴别 

分 类 号：R222.2[医药卫生—中医基础理论]