对《金匮要略》中“阳微阴弦”再认识  

Recognition of "Weak Pulse at Yang and Stringy Pulse at Yin" in Synopsis of the Golden Chamber

作　　者：杨帆[1] 李云海[1] YAN Fan;LI Yunhai(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：《中医学报》2021年第12期2496-2499,共4页Acta Chinese Medicine

基　　金：国家中医药管理局“田玉美全国名老中医药专家传承工作室”项目{国中医药人教函[2012]149}。

摘　　要：张仲景在《金匮要略》中提出"阳微阴弦"理论,通过以脉论理的方法,揭示了胸痹心痛的病因病机,为后世医家治疗胸痹奠定了理论基础。《金匮要略》中,与胸痹类似的还有血痹、奔豚气、腹满,亦可用阳微阴弦来分析病因。血痹之"阳微"即寸脉浅表阳气不足,"阴弦"指风寒二者合邪,阴乘阳位;奔豚气"阳微"是上焦阳气不足于内,"阴弦"指脉象上可见弦紧之象;腹满以"趺阳脉微弦"为总纲,"微弦"是"阳微阴弦"的略称,趺阳脉微指中阳不足,趺阳脉弦即阴寒之邪侵袭阳位,引发疼痛。Zhang Zhongjing put forward the theory of "weak pulse at yang and stringy pulse at yin" in Synopsis of the Golden Chamber.Through the method of pulse theory,he revealed the etiology and pathogenesis of chest arthralgia and heartache,which laid a theoretical foundation for later doctors to treat chest arthralgia.In Synopsis of the Golden Chamber,similar to chest arthralgia,there are blood arthralgia,up-rushing qi,abdominal distension,and weak pulse at yang and stringy pulse at yin can also be used to analyze the etiology.The "weak pulse at yang" of blood stasis refers to the deficiency of yang qi on the surface of inch pulse,and "stringy pulse at yin" refers to the combination of wind and cold,and yin invades yang position.The "weak pulse at yang" of up-rushing qi means that the yang qi of upper Jiao is deficiency in interior,and "stringy pulse at yin" means that the string is tight on the pulse.Abdominal distension takes "weak pulse at yang and stringy pulse at yin of Fuyang channel" as the general outline,"slightly string" is the abbreviation of "weak pulse at yang and stringy pulse at yin".Weak pulse of Fuyang channel refers to the deficiency of Iang in the middle Jiao,and stringy pulse of Fuyang channel,that is,the pathogen of cold,invades yang position and causes pain.

关 键 词：“阳微阴弦” 胸痹 血痹 奔豚气 腹满 《金匮要略》 张仲景 

分 类 号：R222.3[医药卫生—中医基础理论]