《黄帝内经》“死”症的机理探析  

An analysis of the mechanism of "death syndrome" in the Inner Canon of Huangdi

作　　者：蒋林珊 王小平 JIANG Lin-shan;WANG Xiao-ping(College of traditional Chinese medicine,Shandong University Of Traditional Chinese Medicine,Shandong 250355,Chima)

机构地区：[1]山东中医药大学中医学院

出　　处：《中国中医基础医学杂志》2020年第1期11-14,共4页JOURNAL OF BASIC CHINESE MEDICINE

摘　　要：《黄帝内经》中约出现了493次“死”字,不能一概理解为“生命终止”之义,结合《黄帝内经》文意与后世医家探究,笔者认为约414处“死”字应灵活解释为病情紧急、危重难愈或预后较差。同时还有部分字词,如“亡、尽、终、不治、不可治”等也通此义。通过分析《黄帝内经》相关论述,将“死”症的机理归纳为阴阳离决、邪盛正衰、脏气竭绝、脾胃气绝、神气衰亡、经气败绝6个方面,发现以上病机既可单一致“死”,亦可复合相加致“死”,其中脾胃之气的衰微在多种病机中均有体现,故而认为“脾胃气绝”是“死”症的核心病机,因此在临床对于危重病人的救治中要慎察脾胃之气的盛衰变化,时时固守,谨防败坏。明“死”之机理,方能在辨病治病、判断预后、养生康复等过程中把握关键、争取主动。There are about 493“death”characters in the Inner Canon of Huangdi,which can not be understood as the meaning of“end of life”.The author thinks that about 414“death”words should be interpreted flexibly as the condition is urgent,critically difficult or poor prognosis.At the same time,there are also some words,such as“death,end,no treatment,no cure”and so on.Through the analysis of the relevant thesis of“Inner Canon of Huangdi”,the mechanism of“death”is summarized as the separate of the Yin and Yang,the evil prosperity and the decline,the exhaustion of the Zang Qi,the spleen and stomach qi declining,the decline of the meridian-Qi.It can be consistently“dead” or combined to cause“death”.The decline of spleen and stomach is reflected in many pathogenesis.Therefore,it is considered that“spleen and stomach”is the core pathogenesis of“death”.Therefore,in the clinical treatment of critically ill patients,we must carefully observe the ups and downs of the spleen and stomach,always stick to it,beware of corruption.The mechanism of“death”can grasp the key and strive for initiative in the process of disease differentiation,prognosis,and health rehabilitation.

关 键 词：“死”症 黄帝内经 病机 脾胃之气 

分 类 号：R222.19[医药卫生—中医基础理论]