圆运动视域下之四逆散证病机新解  

New explanation of Sinisan based on the view of circular motion

作　　者：张萌 王芳芳 谭宏韬 林明欣[4] ZHANG Meng;WANG Fang-fang;TAN Hong-tao;LIN Ming-xin(School of Basic Medical Sciences,Guangxi University of Chinese Medicine,Nanning 530200,China;School of Traditional Chinese Medicine,Shanxi Datong University,Datong 037000;Department of Traditional Chinese Medicine,Huizhou Municipal Central Hospital,Huizhou 516000,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]广西中医药大学基础医学院,南宁530200 [2]山西大同大学中医药健康服务学院,大同037000 [3]惠州市中心人民医院中医科,惠州516000 [4]中国中医科学院中医基础理论研究所,北京100700

出　　处：《中华中医药杂志》2022年第2期633-636,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2019YFC1708500);广西中医药大学博士科研启动基金(No.2020BS010)。

摘　　要：四逆散出自《伤寒论》,其病机解析,历代医家见仁见智。文章立足“五行圆运动”,重新思考四逆散证,提出北方水气封藏失权、东方木气升发失序是其核心病机。木气升发之变乱,“上逆”南方可致火气失宣而“悸”,“横逆”中央可致土气失运而“腹中痛”,“直逆”西方可致金气失收而“咳”,“陷逆”北方可致水气封藏失权加剧而现“小便不利”“泄利下重”。要之,北方及东方圆运失衡作为本证关键,牵“一方”而动“四方”,导致“四逆”的同时,尚可表现出五类“或然症”。借“五行圆运动”思维,为方证辨识提供新视角,有助迅速把握方机,提高临床疗效。The syndrome of Sinisan which comes from Treatise on Febrile Diseases is often discussed as a difficult problem by doctors of ancient and modern. Based on the view of ‘circular motion of five elements’, this paper takes a fresh look at the syndrome of Sinisan. The core pathogenesis is the deficiency of northern water qi and the depression of eastern wood qi.The chaos of wood qi can cause obstruction of southern fire qi to happen palpitation, stagnation of central earth qi to happen abdominal pain, upward reversal of western metal qi to happen cough and depleting downward of northern water qi to happen disorder of stool and urine. Therefore, it can be seen that the maladjustment of northern and eastern qi is the key to the syndrome,which affects the whole body. This can lead to cold limbs and five other possible symptoms. Borrowing ‘circular motion of five elements’, it provides a new perspective for the identification of formula-syndrome, which helps to grasp the pathogenesis quickly and improve the clinical efficacy.

关 键 词：四逆散 四逆 圆运动 病机 疗效 

分 类 号：R289.5[医药卫生—方剂学]