《伤寒杂病论》癫狂病证治思路探析  

Analysis on Syndrome Differentiation and Treatment of Manic-depressive Psychosis in Treatise on Cold Pathogenic and Miscellaneous Diseases

作　　者：彭爱能 赵永厚 赵玉萍 于明 PENG Aineng;ZHAO Yonghou;ZHAO Yuping;YU Ming(Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang Mental Hospital,Harbin 150036,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江神志医院,黑龙江哈尔滨150036

出　　处：《山东中医药大学学报》2023年第1期7-11,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:81873299)。

摘　　要：《伤寒杂病论》所论述癫狂病实证较多,主要集中在太阳病篇及阳明病篇。太阳病所致癫狂病为太阳经感邪,失治误治,传变入里,致邪气壅滞,郁而化热,或素体阳亢,感邪之后,火热更甚,发为癫狂;阳明病所致癫狂病,为阳明燥热太过,热与糟粕相结,热与血结,或热甚津液大伤,形成阳明腑实、阳明蓄血、阳明热甚伤津证。癫狂病治疗以清热、泻下、活血散瘀为主,但临床上容易出现虚实夹杂、寒热错杂等复杂病情,故张仲景在治疗时强调“观其脉症,知犯何逆,随证治之”,切不可拘泥于某一种治法。Manic-depressive psychosis in Treatise on Cold Pathogenic and Miscellaneous Diseases commonly appeared in excess syndromes,mainly in the articles on Taiyang disease and Yangming disease. Manic-depressive psychosis due to Taiyang disease is caused by Taiyang meridian contraction pathogen,lack of proper treatment or misuse of treatment,which is transmitted into the interior,leading to stagnation of pathogenic qi,transforming into heat. Or constitutional yang hyperactivity,after contraction pathogen,heat and fire are getting severe,developing into manic depression. Manic-depressive psychosis due to Yangming disease is caused by excessive dryness and heat in Yangming meridian,accumulation of heat and waste,heat and blood,or severe heat damaging body fluids,developing into fu-organ excess syndrome of Yangming,blood accumulation syndrome of Yangming and severe heat of Yangming damaging body fluids syndrome. Clearing heat,purging,activating blood and resolving stasis are mainly used in the treatment of manic-depressive psychosis. It is easy to cause the complicated conditions of deficiency-excess in complexity and coldheat complex,etc. in the clinical practice,so ZHANG Zhongjing emphasized that “pulse examination can reveal its adverseness and can make it clear how to treat such a syndrome”,at the same time,it should not be limited in a certain treatment.

关 键 词：《伤寒杂病论》 张仲景 癫狂病 太阳病 阳明病 精神分裂症 谵语 清热 泻下 活血散瘀 

分 类 号：R222[医药卫生—中医基础理论]