《金匮要略》之黄汗、历节合考  

Combined Textual Research of Yellow Sweat and Li Jie in Synopsis of Golden Chamber

作　　者：殷鸣[1] 张琦[1] YIN Ming;ZHANG Qi(Chengdu University of Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学,成都610075

出　　处：《中国中医基础医学杂志》2022年第4期497-499,506,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：四川省社会科学重点研究基地重点项目(2021C02)-基于秦汉出土简帛医方的《伤寒杂病论》的方药源流研究与病证体系演进研究。

摘　　要：黄汗、历节是《金匮要略》中的病名,黄汗以汗出黏衣、色黄如柏汁为特征,而历节以关节剧烈疼痛、变形为主症,二者临床表现大异但同得之于汗出入水,其病机、治法有相通之处。在卫表空虚的情况下,水湿得以侵入机体深层。黄汗为营分之郁热,为水湿与脾胃之热相合;历节为营血之瘀滞,为水湿与肝肾之虚相并。《金匮要略》以两胫发热作为黄汗、历节的区别,黄汗、历节病位深浅不同,两胫发热是水湿侵入下焦筋骨的特征性症状。在治法上张仲景治疗黄汗并不着眼于既成的湿热,而是注重汗出入水的病因,以补卫和营为法;治疗历节不局限在新感的寒湿而注重卫表空虚的病机,以助卫托邪为法,体现了《金匮要略》重视整体、重视正气的辨证思想。YellowSweat and Li Jie are the names of diseases in Synopsis of Golder Chamber.Yellow Sweat is characterized by sticky sweating and yellowish color like cypress juice,while Li Jie is characterized by severe joint pain and deformation.The symptoms of the two are quite different,but they are both caused by sweating in the water,so there are similarities in pathogenesis and treatments.In the case of the emptiness of the WeiQi,cold and dampness evils invade the deep layers of the body.Yellow Sweat is caused by the stagnation and heat in the YingFen,which is the combination of water dampness and the heat of the spleen and stomach.Li Jie is caused by the stagnation of blood stasis,which is the combination of water dampness and the deficiency of liver and kidney.Synopsis of Golder Chamber regards the fever in the two tibias as the difference between Yellow Sweat and Li Jie.Yellow Sweat and Li Jie have difference in the depths of location.The fever in the two tibias is a characteristic symptom of water and dampness invading the lower jiao and the bones.In the treatment of Yellow Sweat,ZHANG Zhong-jing does not focus on the damp-heat,but to see the etiology of sweating.He adopts the method of regulating Ying and Wei.In the treatment of Li Jie,hedoes not focus on the cold and dampness,but to see the pathogenesis of the emptiness of the WeiQi.He adopts the method of helping the WeiQi to drive out the evil.This reflects the emphasizes of the whole and the vital Qi in Synopsis of Golder Chamber.

关 键 词：《金匮要略》 汗出入水 黄汗 历节 助卫托邪 

分 类 号：R222.3[医药卫生—中医基础理论]