《金匮要略》湿病再思考  

Rethink on Dampness Disease in Synopsis of the Golden Chamber

作　　者：孙海燕[1,2] SUN Haiyan(Zhejiang Chinese Medical University,Hangzhou(310053),China;Zhejiang Provincial Hospital of TCM)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江省中医院

出　　处：《浙江中医药大学学报》2022年第5期497-500,511,共5页Journal of Zhejiang Chinese Medical University

基　　金：陈意全国名老中医药专家传承工作室建设项目(国中医药人教发[2011]41号);第六批全国老中医药专家学术经验继承工作项目(国中医药人教发[2017]29号);浙江省陈意国医名师传承工作室建设项目(浙中医药[2020]12)。

摘　　要：[目的]在厘清“湿”“湿气”“湿邪”“湿病”概念的基础上,对《金匮要略》湿病再次进行思考研习,以明仲景心法,以助益临床。[方法]通过剖析“湿”“湿气”“湿邪”“湿病”的概念,阐释《金匮要略》中湿病狭义与广义之不同,从广义湿病的诊断、鉴别诊断、转变及转归预后等角度,思考并研习仲景对于湿病的认知思路。[结果]《金匮要略》之湿病可有广义和狭义之分。狭义之“湿病”,即“湿痹”;广义之“湿病”多达25种,仲景以主症、主脉定义或诊断疾病,以病为纲;在湿病的诊断过程中亦穿插了病证鉴别思想、点明了病证鉴别关键;同一病因下,仲景看到不同湿病互相转变的动态性,重视湿病的转归预后。[结论]《金匮要略》论湿病,全面分析了湿病的诊断、鉴别、转变到转归预后,对于湿病的认知全面立体,值得研习,以助临床见病知源、见病明异、见病识变。[Objective] To rethink and study on dampness diseases in Synopsis of the Golden Chamber from the perspectives of “damp”“dampness Qi” “pathogenic dampness” and “dampness disease”, in order to show Zhongjing’s principles. [Methods] Through combing the conceptions of “damp” “dampness Qi” “pathogenic dampness” and “dampness disease” and analyzing dampness diseases in Synopsis of the Golden Chamber from narrow and broad sense, the article rethought and studied Zhongjing’s cognitive thoughts from diagnosis,differential diagnosis, transition and prognosis aspects. [Results] Dampness diseases in Synopsis of the Golden Chamber can be divided into broad and narrow senses. The narrow one is just arthralgia induced by dampness, while the broad one is as much as twenty-five kinds of diseases, which are taken as classifications. Zhongjing defined and diagnosed the diseases by the primary symptom or the typical pulse.During the diagnostic process of dampness diseases, he also interluded the thoughts of differential diagnosis and pointed out the key for diagnosis. Even under the same etiological factor, he indicated the dynamic natures of different dampness diseases and emphasized the importance to clinical outcome and prognosis. [Conclusion] Dampness diseases in Synopsis of the Golden Chamber are comprehensively presented from the aspects of diagnosis, differential diagnosis, transition and prognosis. Such all-round cognitive thinking is worth learning, in order to know the reasons, the differences and the changes of diseases.

关 键 词：金匮要略 湿 湿气 湿邪 湿病 张仲景 

分 类 号：R221[医药卫生—中医基础理论]