基于张仲景著作中小便利与不利的比较研究  

A Comparative Study on Normal Urination and Dysuria of ZHANG Zhongjing’s Works

作　　者：刘旎 戴明[1] 傅延龄[1] LIU Ni;DAI Ming;FU Yanling(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：《中国中医基础医学杂志》2023年第2期193-197,共5页JOURNAL OF BASIC CHINESE MEDICINE

摘　　要：从概念内涵、病理机制、诊断意义和辨证治疗4个方面对张仲景著作中小便利与不利的相关原文进行了系统梳理与比较分析,以明晰二者之间的联系与区别。内涵方面:对小便利在生理与病理层面的含义作出完善。病机方面:小便利与不利均为阳气虚损、水液偏渗、水饮停蓄及津液亏虚的外应,均可反映机体津液的盈虚通滞。但二者所提示的阳虚程度、水液偏渗的部位、水饮停蓄的病位及津亏的病理阶段有所不同。诊断意义方面:小便利与不利均为水液代谢障碍类疾病的诊治眼目,二者是蓄血证瘀血与热结程度、黄病虚实寒热病性及黄汗病病理阶段的鉴别要点。辨治方面:基于气难化津这一共同病机,八味肾气丸、五苓散等用于治疗小便利与不利是异病同治的体现。This paper systematically combs and compares the relevant original texts about normalurination and dysuria of ZHANG Zhongjing’s works from four aspects:conceptual connotation,pathological mechanism,diagnostic significance and syndrome differentiation and treatment,so as to clarify the relationship and difference between them.In terms of connotation,improve the meaning of normal urination at the physiological and pathological levels.In terms of pathogenesis,normal urination and dysuria are the external response of Yang deficiency,partial infiltration of body fluids,fluid retention and deficiency of body fluids,which can reflect the surplus,deficiency and stagnation of body fluids.However,the degree of Yang deficiency,the location of water leakage,the location of water retention and the pathological stage of fluid deficiency are different.In terms of diagnostic significance,normal urination and dysuria are the eyes for the diagnosis and treatment of body fluids metabolism disorders.They are the key points for the differentiation of blood stasis and heat knot degree of blood accumulation syndrome,deficiency and excess cold and heat disease of jaundice and pathological stage of yellow sweat disease.In terms of syndrome differentiation and treatment,based on the common pathogenesis of "Qi is difficult to transform body fluid",it can be seen that Bawei Sheng:Pill and Wuling Powder can be used to treat normal urination and dysuria,which is the embodiment of the same treatment of different diseases.

关 键 词：小便利 小便不利 张仲景 水液代谢 比较研究 

分 类 号：R222[医药卫生—中医基础理论]