从经方病传理论探讨《金匮要略》黄疸病机演变  

Discussion on jaundice's pathogenesis in the Synopsis of the Golden Chamber from the transmission theoryof classical prescription

作　　者：张哲源 曹灵勇[2] 许家栋 林树元[2] ZHANG Zhe-yuan;CAO Ling-yong;XU Jia-dong;LIN Shu-yuan(The First Clinical School of Zhejiang Chinese Medical University,Hangzhou 310053,China;College of Basic Medical Sciences,Zhejiang Chinese Medical University,Hangzhou 310053,China;Hangzhou West Lake Institute of Traditional Chinese Medicine,Hangzhou 310012,China)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学基础医学院,杭州310053 [3]杭州西湖中医经方研究院,杭州310012

出　　处：《中华中医药杂志》2022年第12期6980-6983,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江中医药大学横向(涉企)项目(No.2020-HT-161,No.2020-HT-837)。

摘　　要：文章基于《金匮要略》原文,从经方病传理论出发,探讨黄疸的病传规律,结合《伤寒论》相关原文,提出黄疸以太阴中风及水热蕴结为主因,以谷疸为主证,由黄汗病传所致。其病证演变规律:太阴中风在黄汗阶段形成水热熏蒸,属黄疸前期;当其表邪入里、虚热转实,形成阳明水热蕴结,即为谷疸;在传变过程中会经历太阴阳明合病的过渡阶段,即“欲作谷疸”;当谷疸水热蕴结日久、化燥伤津,即形成虚劳发黄之“黑疸”。此外,谷疸之水热需与女劳疸之血热相鉴别,属于水气篇中水血辨证之延伸。Based on the original text of the Synopsis of the Golden Chamber,starting from the theory of disease transmission of classic prescriptions,this article discusses the law of disease transmission of jaundice,combined with the relevant original text of Treatise on Cold Pathogenic Diseases,and proposes that jaundice is mainly caused by Taiyin stroke and hydro-heat accumulation,and the main card is dietary jaundice.The card is caused by yellow sweat.The evolution law of its syndrome is as follows:Taiyin stroke forms hydrothermal fumigation during the yellow sweat stage,which belongs to the pre-jaundice;when the external evil enters the inside,the deficiency and heat turns to solid,the Yangming hydrothermal accumulation is formed,which is dietary jaundice;During the process,it will experience the transitional stage of Taiyin Yang Ming syndrome,that is,‘desire to make dietary jaundice’.In addition,the water-heat of dietary jaundice needs to be distinguished from the blood-heat of female labor jaundice,which is an extension of water-blood differentiation in the chapter on water and air.

关 键 词：黄疸 谷疸 黄汗 太阴中风 病传 伤寒论 金匮要略 

分 类 号：R259[医药卫生—中西医结合]