刍议淋证之湿  

On Dampness of Strangury

作　　者：陈冠文 于思明[2] CHEN Guanwen;YU Siming(Heilongjiang University of Chinese Medicine,Harbin Heilongjiang China150040;The First Affiliated Hospital ofHeilongjiang University of Chinese Medicine,Harbin Heilongjiang China 150040)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中医学报》2021年第9期1872-1875,共4页Acta Chinese Medicine

摘　　要：古代医家皆谓淋证之病机为膀胱热;当今医家多以湿热蕴结下焦作为淋证病机,治法为清热利湿通淋。由膀胱热转变为膀胱湿热可能与五行论之传播有关;浊、带、淋之相兼而论亦可能造成医家对淋证认识混乱;且明清以降,湿热理论逐渐泛化,造成无病不湿的局面。考淋证症状与利湿治法可发现,若利湿指利小便以增加尿量则不妥,尿为生理之液,与湿不能等同;若利湿指宣畅三焦,运化脾湿,则古代皆称之为化湿;若利湿指排除体内外感之湿邪,然淋证之病机多以热邪盘踞下焦膀胱为主,与外感湿邪关系不大。故淋证病机应为膀胱热,与湿的关系并不密切,利湿这一治则用语失于妥当。Ancient doctors said that the pathogenesis of strangury was damp-heat of bladder;nowadays, doctors mostly take the accumulation of damp-heat in lower Jiao as the pathogenesis of strangury, and the treatment method is clearing heat, promoting diuresis and freeing strangury.The transition from bladder heat to bladder damp-heat of bladder may be related to the spread of the five elements theory;The combination of turbidity, leucorrhea and drenching may also cause confusion in doctors′ understanding of strangury;since the Ming and Qing Dynasties, the damp heat theory has gradually generalized, resulting in the situation of no disease caused by dampness.According to the symptoms of strangury and the method of promoting diuresis, if dampness refers to urination to increase urine output, it is inappropriate.Urine is a physiological fluid, which is not equal to dampness;in ancient times, it was called dampness removing if dampness removing refers to dispersing the Sanjiao and removing dampness from the spleen;if promoting diuresis means eliminating the dampness pathogen in the body and outside, the pathogenesis of strangury is mainly heat pathogen entrenching in the lower Jiao of bladder, which has little to do with the dampness pathogen in the outside.Therefore, the pathogenesis of strangury should be bladder heat, which is not closely related to dampness, and the term of promoting diuresis is inappropriate.

关 键 词：淋证 湿邪 膀胱热 膀胱湿热 清热利湿通淋 

分 类 号：R256.52[医药卫生—中医内科学]