《伤寒论》131~134条“结胸”之辨析  

Analysis of“knotted chest(jie xiong)”in clause 131-134 of Treatise on Febrile Diseases

作　　者：李国炜[1] 王明炯[2] 姜靖茜 奚小土[1] LI Guowei;WANG Mingjiong;JIANG Jingxi;XI Xiaotu(Department of Emergency,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;College of Traditional Chinese Medicine,Changsha Medical College,Changsha 410219,China)

机构地区：[1]广东省中医院急诊科,广东广州510120 [2]湖南省长沙医学院中医学院,湖南长沙410219

出　　处：《医学争鸣》2020年第6期18-20,23,共4页Negative

基　　金：广东省中医药局科研基金(20171113)。

摘　　要：本文从逻辑和医理两个方面对《伤寒论》中论述结胸的条文进行了重新考证,从条文前后逻辑矛盾入手,并且结合康平古版《伤寒论》中的对应条文综合分析,最终得出结论:①"结胸"一证充满了复杂性和矛盾性,与"脏结"一证非常类似,迫使张仲景在行文中不得不反复鉴别,并且用语矛盾。②宋版《伤寒论》中134条的论述加入了后世的注解,而康平古版《伤寒论》更符合仲景本意。This paper studied the clauses on the knotted chest in Treatise on Febrile Diseases from the aspects of logic and medicine.Based on the analysis on the logical contradiction in the clauses and the comprehensive analysis on the corresponding clauses of ancient edition of Treatise on Febrile Diseases by Kang Ping,the following conclusions are drawn:①the“knotted chest”,similar to“mass of internal organs(zang jie)”,is full of complexity and contradiction,which forces Zhang Zhongjing to identify the differences repeatedly in his book.②The authors think that the clause 134 in the Song edition of Treatise on Febrile Diseases are added with the annotation by later generations,while the ancient edition of Treatise on Febrile Diseases by Kang Ping is more in line with the original intention of Zhang Zhongjing.

关 键 词：张仲景 结胸 下法 大陷胸汤 大陷胸丸 脏结 烦躁 

分 类 号：R22[医药卫生—中医基础理论]