《伤寒论》治疗口渴的常变法探讨  

Discussion on Regular and Transmuted Methods of Treating Thirst in Treatise on Febrile Diseases

作　　者：范淑月 倪钰莹 孙彤彤 吴璐蔚 刘敏[1] FAN Shuyue;NI Yuying;SUN Tongtong;WU Luwei;LIU Min(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029

出　　处：《辽宁中医杂志》2022年第10期54-57,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81774375);国家中医药管理局中医学术流派传承工作室第二轮建设项目(国中医药办人教函[2019]62号);国家中医药管理局全国名中医王庆国传承工作室建设项目(国中医药办人教函[2018]119号)。

摘　　要：口渴是临床上常见的症状之一,以口中干燥,且欲饮水为表现,多由体内津液不足或津液输布障碍所致。《伤寒论》是一本辨证论治的专著,纵观全文,张仲景十分重视对口渴的治疗,除了运用清热生津、饮水止渴等常法治渴外,还进一步阐常述变,提出了多种治渴变法,充分体现了“观其脉证,知犯何逆,随证治之”的辨证论治精神实质。根据《伤寒论》中所记载的治渴条文,列举少少与饮之自愈疗法、清热生津之白虎加人参汤和瓜蒌根等常法,以及蠲化水饮之小青龙汤、健脾散津之白术、通阳化气之五苓散、急救回阳之四逆汤、育阴利水之猪苓汤、急下存阴之大承气汤等变法,从“知常达变”的角度,探讨中医常变思维在《伤寒论》治疗口渴中的具体运用及特点。论述常法与变法代表方药的理论依据、辨证要点及用药指征,并附验案一则为佐证,以期拓宽临床治疗口渴的思路与方法。Thirst is one of the common clinical symptoms,characterized by dry mouth and desire to drink water,which is often caused by the lack of body fluid or the disturbance of body fluid transfusion.Treatise on febrile Diseases is a monograph on syndrome differentiation and treatment.Throughout the book,ZHANG Zhongjing attached great importance to the treatment of thirst.In addition to treating thirst with the regular methods,such as clearing heat and promoting fluid production,drinking water to quench thirst,he also explained a variety of transmuted patterns of thirst and their corresponding treatments.It fully embodies the spirit of“observing the pulse and signs,knowing what mistakes have been made,and treating according to the presenting syndrome”.This article summarized the lines about thirst in Treatise on Febrile Diseases and enumerated some regular methods,such as self-healing therapy of drinking small amounts of water,Baihu plus Renshen Decoction(白虎加人参汤)and Gualougen(Trichosanthis Radix)of clearing heat and promoting fluid production.It also enumerated some transmuted methods,such as Xiaoqinglong Decoction(小青龙汤)of warming Yang and dispersing fluid,Baizhu(Atractylodes macrocephala)of strengthening spleen and transporting body fluid,Wuling Powder(五苓散)of unblocking Yang and transforming Qi,Sini Decoction(四逆汤)of urgently restoring Yang,Zhuling Decoction(猪苓汤)of nourishing Yin and promoting urination,Dachengqi Decoction(大承气汤)of timely purging to preserve Yin.From the perspective of“know the regularity to master the transmutation”,this paper aimed to discuss the application and characteristics of TCM flexible thinking in the treatment of thirst in Treatise on Febrile Diseases.Then it discussed the theoretical basis,key points of syndrome differentiation and medical indications of the representative formulae of the regular methods and the transmuted methods.Finally by using a case as evidence,it is expected to broaden the thinking and methods of clinical treatment of

关 键 词：口渴 理法方药 知常达变 《伤寒论》 张仲景 

分 类 号：R222[医药卫生—中医基础理论]