基于方证辨证浅析奔豚气病的病机与证治  

Analysis on the Pathogenesis and Treatment of Bentun Qi Disease Based on the Prescription and Syndrome Differentiation

作　　者：周雨龙 司廷林[2] ZHOU Yulong;SI Tinglin(Shandong University of Traditional Chinese Medicine,Ji′nan Shandong China 250014;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji′nan Shandong China 250001)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学第二附属医院,山东济南250001

出　　处：《中医学报》2022年第4期723-727,共5页Acta Chinese Medicine

基　　金：山东省中医经典名方协同创新中心项目(2019KFY08)。

摘　　要：奔豚气病位在肾,气之源头为肾间动气,任冲二脉为气之通路,其根本病机为肾阳虚损,水饮作为关键病理因素贯穿疾病始终。阴证奔豚即肾积奔豚,因肾中寒水留积,致动气沿任脉上冲形成,此属虚寒证;阳证奔豚因寒水郁遏相火,相火妄动,则动气经冲脉上逆,致奔豚气发作,实为虚热证。《金匮要略》以三方治疗奔豚气,侧重不同:桂枝加桂汤温肾、苓桂甘枣汤化饮、奔豚汤清降相火,临床可随证选方。Bentun qi disease is located in the kidney.The source of Qi is the movement of Qi between the kidneys, and Ren channel and Chong channel are the pathway of qi.Its fundamental pathogenesis is the deficiency of kidney yang, which is divided into yin and yang.Fluid is the key pathological factor throughout the disease.Yin Syndrome of Bentun refers to kidney accumulation Bentun.Due to the accumulation of cold water in the kidney, it causes qi to rush up along the Ren channel, which belongs to deficiency cold syndrome;Yang Syndrome of Bentun suppresses phase fire due to cold water depression.If phase fire moves rashly, it will move Qi upward through the Chong channel, resulting in the attack of Bentun qi.In fact, it is deficiency heat syndrome.Synopsis of the Golden Chamber treats Bentun qi with three prescriptions, focusing on different aspects.Guizhi Jiagui Decoction warms the kidney, Linggui Ganzao Decoction Huayin and Benfu Decoction clear and reduce phase fire.Clinically, the prescriptions can be selected according to the syndrome.

关 键 词：奔豚气病 方证辨证 桂枝加桂汤 苓桂甘枣汤 奔豚汤 《金匮要略》 张仲景 

分 类 号：R256.59[医药卫生—中医内科学]