解读太阳病的分类  

Discussion on the classification of Taiyang disorders

作　　者：马玉杰 程引 宋长恒[1] 张治国[1] Ma Yujie;Cheng Yin;Song Changheng;Zhang Zhiguo(Institute of Basic Theory,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700

出　　处：《北京中医药大学学报》2021年第7期597-604,共8页Journal of Beijing University of Traditional Chinese Medicine

基　　金：中央级公益性科研院所基本科研业务费专项(No.YZ-1867,No.YZ-202035);全国中医药创新骨干人才培训项目(No.国中医药人教函[2019]128号)。

摘　　要：对太阳病的分类古今均有争议。本文回顾了历代医家对太阳病的认识,提出太阳病指的是邪气在表,正邪交争的一系列病症。在此基础上,进一步分析了温病与太阳病的关系、温病与风温的关系,痉、湿、暍病与太阳病的关系等3个古今争议的问题。认为温病是太阳病的一种类型,主方为白虎汤,而风温从属于温病,是因发汗不当而导致的,痉、湿、暍病皆属于太阳病。同时,基于邪气性质和受病者体质,重新解读了太阳病的分类,认为太阳病应包含中风、伤寒、痉病、中湿、中暍、温病、风水7个类型,并探索治疗不同类型太阳病的主药,提出麻黄、石膏、黄芪为走表专药,而桂枝、葛根、栝楼根、白术、防己为表里同治药,表里同治药通过适当配伍,可使其在表发挥作用。最后,从《伤寒论》的形成过程分析了导致太阳病分类争议的原因,认为太阳病提纲存在一定的局限性。The controversies on the classification of Taiyang disorders in Shanghan Lun(Treatise on Cold-Induced Diseases)were reviewed in this paper.Taiyang disorders refer to a series of patterns resulting from pathogenic factors that invade the exterior fighting with healthy qi.The relationships between Taiyang disorders and warm diseases,between warm diseases and wind-warm diseases,as well as between Taiyang disorders and convulsion,dampness and summer-heat diseases were also discussed in this paper.Warm diseases is included in Taiyang disorders and should be treated with Baihu Tang(White Tiger Formula);wind-warm disease is a kind of warm disease caused by improper sweating;convulsion,dampness and summer disease all fall into the category of Taiyang disorders.At the same time,based on the nature of pathogenic factors and the constitution of the patients,Taiyang disorders were reclassified in this article into wind attack,cold damage,convulsion,dampness attack,summer attack,warm disease and wind edema.Besides,the main herbs for different types of Taiyang disorder were explored.Mahuang(ephedra,HerbaEphedrae),Shigao(gypsum,Gypsum Fibrosum)and Huangqi(astragalus root,Radix Astragali)were for exterior pattern,while Guizhi(cassia twig,Ramulus Cinnamomi),Gegen(pueraria root,Radix Puerariae Lobatae),Gualougen(snakegourd root,Radix Trichosanthis),Baizhu(white atractylodes rhizome,Rhizoma Atractylodis Macrocephalae),and Fangji(four stamen stephania root,Radix Stephaniae Tetrandrae)were for treating both the exterior and interior,which can act in the exterior through proper combination.Finally,the causes of the controversies on the classification of Taiyang disorders were analyzed based on the formation of Treatise on Cold-Induced Diseases,and the limitations of general symptoms for Taiyang disorderswere discussed.

关 键 词：伤寒论 太阳病 分类 温病 提纲证 

分 类 号：R222[医药卫生—中医基础理论]