从正邪盛衰浅析桂枝汤证之“营弱卫强”心悟  

Comprehension on“Yingruo Weiqiang”of Guizhi Soup from Good and Evil Ups and Downs

作　　者：李连勇 许赋瑜 LI Lianyong;XU Fuyu(Department of 1st District of TCM,Fuding Hospital Affiliated to Fujian University of TCM,Fuding Fujian 355200,China)

机构地区：[1]福建中医药大学附属福鼎医院中医内科一区,福建福鼎355200

出　　处：《中国卫生标准管理》2020年第7期114-116,共3页China Health Standard Management

摘　　要：桂枝汤为伤寒第一方,主治病证为“营弱卫强”,而临床医家对“营弱卫强”含义未有统一结论,笔者认为应从正邪盛衰来解释其含义,即各种病因导致脾胃受损,生化不及则营弱,卫气充养不及,腠理开,营不内守,营更弱,故“营弱”即为表虚之意;表虚,腠理开,邪有犯正之机,卫阳尚能奋起抗邪,故曰“卫强”。从正邪盛衰角度来看,桂枝所主治病证包括卫强御邪于外,卫强抗邪于外及太阳中风,卫强与邪相持于太阳三个阶段。证候表现出“卫开营泄”状态,以低热、自汗出为主要辨证要点,需排除脏腑病变继发所致,也不适合阳热淫邪中太阳之病证。可知桂枝汤乃滋营阴、充卫阳之补益方剂,通过强营卫、扶助正气以固表祛邪。Guizhi soup is the first choice for typhoid fever.The main treatment is“Yingruo Weiqiang”.Clinical physicians have no uniform conclusion to the meaning of“Yingruo Weiqiang”.The author thinks the meaning should be explained from good and evil ups and downs.In other words,various etiolgical factors resulting in damaging the spleen and stomach.Insufficient biochemistry results in Yingruo,while sufficient Weiqi results in striae.Without protection,Ying will be weaker,“Yingruo”means exterior deficiency.Exterior deficiency results in striae,showing that the evil may damage the good.Weiyang can resist evil,so there is“Weiqiang”.From the perspective of the ups and downs of Good and evil,Guizhi's disease treatment includes three stages of Weiqiang against evil,Weiqiang against evil and sun stroke,than Weiqiang and evil adhere to the sun.The syndrome shows the state of“Weikai Yingxie”.The main differentiation points include low fever and spontaneous perspiration.Viscera lesion’s secondary onset should be exclude.It is not suitable for Taiyang's disease,showing that Guizhi soup can nourish Yingyin and enrich nutrition.To strengthen Yingwei and help integrity can intensity the surface and eliminate evil.

关 键 词：桂枝汤 营弱卫强 卫开营泄 正邪盛衰 阶段 心悟 

分 类 号：R25[医药卫生—中医内科学]