《伤寒论》目与神志病  

On Eyes and Mental Diseases in Treatise on Cold Damage Diseases

作　　者：田娇 樊讯[1] TIAN Jiao;FAN Xun(Hubei University of Chinese Medicine,Wuhan,Hubei,China,430065)

机构地区：[1]湖北中医药大学,湖北武汉430065

出　　处：《河南中医》2020年第10期1459-1462,共4页Henan Traditional Chinese Medicine

基　　金：湖北中医药大学中医药传承与创新计划项目(2018-100804)。

摘　　要：《伤寒论》中视觉失司或因误治津亏,失于濡养;或因阳明腑实,真阴耗伤;或是正邪交争,阳气欲出;或因正气不足,毒热上扰等。目中不了了是由于太阳表证入里成阳明腑实证,当急下救阴,方用大承气汤;直视谵语多由胃火炽盛,当急用缓脱救逆之法;目瞑乃药后暝弦,表面凶险,实为一种治疗的有效反应;眼中生花与肝经相关,治疗上除要泻肾中浊邪,又要注重疏肝。眼之开阖应天地之变化,不寐或多寐,均易引起神志异常。亡阳,使神失所养,致睡眠障碍,治以桂枝去芍药加蜀漆牡蛎龙骨救逆汤或干姜附子汤;胃中津亏不得眠,少少与饮之,胃和则安卧;热扰不得眠,以栀子豉汤、大承气汤、猪苓汤、黄连阿胶汤治疗;正气不足嗜卧,以调补正气之丸药恢复正气;阳明热扰欲眠,以白虎汤滋阴清热;肾阳虚欲寐,以四逆汤为基础方回阳救逆。目赤为少阳中风,治当和解,以小柴胡汤为基础方;目血病情危重,当急以救阴回阳止血之法治疗。According to Treatise on Cold Damage Diseases,the visual loss is due to improper treatment leading to deficiency of body fluid and nourishment;or due to excess of yangming fu-organs leading to consuming real yin,or due to struggle between healthy qi and pathogenic qi leading to flowing yang qi;or due to deficient healthy qi and toxin-heat disturbing upward,etc.For blurred vision,it is because that taiyang exterior syndrome has entered and transformed into excess of yangming fu-organs syndrome,the treatment should focus on emergent purgation to preserve yin,Major Purgative Decoction can be used to purge yang and save yin.For euthyphoria and deliriumdue to excessive stomach fire,the treatment should focus on mild tonification to save from collapse.In terms of closed eyes,it is dizziness with nausea after taking medicine,which is dangerous on the surface and is actually an effective response to treatment.Having sparks in eyes is related to the liver meridian.In addition to purging the turbid pathogen in the kidney,attention should be paid to soothing the liver.The opening and closing of the eyes should be in accordance with the changes of heaven and earth.Insomnia or somnolence can easily lead to abnormal mental state.Yang exhaustion leads to loss of nourishment of spirit,then causes sleep disorders.Cinnamon Twig Decoction Removing Peony combined with Folium Dichroae and Concha Ostreae and Os Draconis Cold Extremities Decoction or Rhizoma Zingiberis and Aconite Decoction can be used.For insomnia due to insufficient fluid in the stomach,a small amount of water fluid can be given,then harmony of stomach will cause good sleep.For insomnia due to excessive heat,Gardenia and Semen Sojae Praeparatum Decoction,Major Purgative Decoction,Polyporus Decoction,Coptis and Colla Corii AsiniDecoction can be used.For love for lying down,pills for nourishing and restoring healthy qi can be used.For desire for sleep due to yangming heat,White Tiger Decoction can be used for nourishing yin and clearing away heat.For desire for sleep d

关 键 词：目 神志病 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]