从《金匮要略》方证治法理解“随其所得而攻之”  

Understanding of“Attacking Therapies Can be Used According to Pathogenic Factors That Have Attacked It”Theory from“Synopsis of The Golden Chamber”Based on Prescriptions and Treatment Methods

作　　者：李思璇 江泳[1] Li Sixuan;Jiang Yong(Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China)

机构地区：[1]成都中医药大学,四川成都610075

出　　处：《成都中医药大学学报》2022年第4期22-25,共4页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(61801058)。

摘　　要：“夫诸病在脏,欲攻之,当随其所得而攻之。”出自于《金匮要略•脏腑经络先后病脉证第一》第17条,是杂病诊疗中具有指导性和概括性的治法,其后言“如渴者,与猪苓汤,余皆仿此”。有学者认为此处有错漏,诸多医家提出不同的观点,对本条的理解尚存争议。本文从在“脏”“所得”“攻之”的描述特征,联系《金匮要略》全书病症治法、理法方药,再结合临床上对书中相关疾病的观察与经验探讨,认为此条应理解为深入综合分析机体“所得”病邪的病位、病性、程度、侧重各个方面,选择精当的治法方药,祛除机体中的邪实部分。而猪苓汤证为机体所得水邪郁热,水热互结于下焦,因此用猪苓汤利水攻邪,而恰是对本条的例证。“In treating visceral diseases,attacking therapies can be used according to the pathogenic factors that have attacked it.”It comes from Article 17 of“Synopsis of the Golden Chamber”:The first disease and pulse syndrome of viscera and meridians,which is a guiding and general treatment method in the diagnosis and treatment of miscellaneous diseases.It is later said that“For instance,if the patient is thirsty,Zhuling Decoction can be used to treat it.Similar treatment can be applied for all other cases.”Some scholars think that there are mistakes and omissions.Many doctors have put forward different views,and the understanding of this article is still controversial.Based on the description of“Zang”,“the pathogenic factors”and“attack”,combined with the clinical observation and experience of relevant diseases in the book,this article should be understood as a comprehensive analysis of the disease location,disease nature,degree,emphasis on all aspects of the body“get”disease,select the appropriate treatment prescription and medicine to eliminate the part of Evil.The syndrome of Zhuling decoction is that the water Evil and Heat Evil are stagnant,and the Water and Heat are combined in the lower Jiao.Therefore,it is an example of this article to use Zhuling decoction to eliminate Water Evil and attack pathogenic factors.

关 键 词：金匮要略 诸病在脏 随其所得 攻之 

分 类 号：R222.3[医药卫生—中医基础理论] R287[医药卫生—中医学]