从“卫出下焦”浅议桂枝去桂加茯苓白术汤证  

Guizhi Decoction without Gui Adding Fuling Baishu Decoction Syndrome from Perspective of "Defensive Qi Coming from Lower Jiao"

作　　者：牛苗苗 张欢[1] 张艺馨 屠晓晓 张效科[1] NIU Miaomiao;ZHANG Huan;ZHANG Yixin;TU Xiaoxiao;ZHANG Xiaoke(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《中医学报》2022年第8期1597-1600,共4页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81774304)。

摘　　要：卫出下焦,其根于肾,肾寓元阴元阳,卫气的生成、运行皆与肾相关。肾合三焦、膀胱,而三焦、膀胱为腠理毫毛之应,相互协同,维持人体正常水液代谢。故卫阳之生成、运行、发挥作用与人体水液代谢亦相关。《伤寒论》第28条所论述之桂枝去桂加茯苓白术汤证乃汗出或误下伤津,水液内停,卫阳被郁而致之太阳蓄水轻证,是以其辨证论治当从“卫出下焦”而论,治以通阳为主。通阳不在温,而在利小便,小便利则水液布散,郁阳得通,诸症可去。Defensive Qi emerges from the Lower Jiao,being rooted in the Kidney.The Kidney stores the renal Yin and renal Yang,and the generation and operation of Defensive Qi are related to the Kidney.The Kidney also corresponds to Sanjiao and bladder,which are correspond to striae and interstitial space and soft hair on the body,and all of them work together to maintain the normal water and fluid metabolism of the human body.Therefore,the generation,operation,and function of the Defensive Yang are also related to the water metabolism of the human body.The syndrome of Guizhi Decoction without Guizhi adding Fuling Baishu Decoction discussed in article 28 of Shang Han Lun refers to the mild syndrome of Taiyang stagnated Fluid caused by sweating damaging body Fluid,resulting in the stagnation of Water and Fluid in the body and the obstruction of the defending yang,which syndrome differentiation and treatment should be based on "defensive Qi from the lower Jiao",the treatment method is mainly activating Yang.The way to activate Yang is not warming Yang but to activate urinateing,which can spread the Water and Fluid out,then the suppressed defending Yang can be dredged and the disease can be cured.

关 键 词：桂枝去桂加茯苓白术汤证 桂枝去桂加茯苓白术汤 “卫出下焦” 太阳蓄水轻证 《伤寒论》 《黄帝内经》 

分 类 号：R222.16[医药卫生—中医基础理论]