从“冲脉不治,取之阳明”解读吴茱萸汤方证  

Interpretation of Wuzhuyu Decoction from Perspective of"Taking Yangming to Solve Chong Meridian Problem"

作　　者：杨菲 张效科[1] 牛苗苗 YANG Fei;ZHANG Xiaoke;NIU Miaomiao(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《中医学报》2023年第8期1648-1652,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81774304)。

摘　　要：“冲脉不治,取之阳明”源于陈修园的《医学从众录》,张锡纯的“冲胃气逆”理论是对其进一步延伸。冲气上逆往往导致胃气逆,所引起病症亦以胃气上逆之表现为主,故陈修园所言“冲脉不治,取之阳明”即指此。吴茱萸汤为现代中医临床的常用方,医家常用以治疗寒邪所致的呕吐、泄泻、疼痛等病证,皆因其有暖肝温胃,散寒降逆之效。冲脉在循行中并于足少阴,隶属于阳明,又通于厥阴,与三经关系密切。少阴肾虚、肝寒犯胃、胃气虚之人,其冲气多不能正常下行,有上冲之弊,以致冲气上逆,冲气上逆又常伴胃气上逆,逆则降之,以吴茱萸汤温中散寒降逆治之,可验陈修园所言:“冲脉不治,取之阳明”。由此,吴茱萸汤何以能治疗阳明、少阴、厥阴之病明矣。The theory of"taking Yangming to solve Chong Meridian problem"is originated from Chen Xiuyuan′s Yi Xue Cong Zhong Lu,and Zhang Xichun′s theory of"Chong Wei Qi Ni"is a further extension of it.Upward movement of Chong Qi often leads to the reversion of Stomach Qi,and the symptoms caused by it mainly include the inversion of Stomach Qi.Therefore,Chen Xiuyuan proposed that"taking Yangming to solve Chong Meridian problem"is just the case.Wuzhuyu Decoction is a commonly used prescription in modern Chinese medicine,which is often used to treat vomiting,diarrhea,pain and other diseases caused by Cold evil factor,because it has the effects of warming the Liver and Stomach,dispelling Cold and lowering the adversed Qi flow.In circulation,Chong Meridian is combined with foot shaoyin,belonging to Yangming,and connected with Jueyin.In other words,it is closely related to these three meridians.With deficiency of Shaoyin and Kidney,Liver Cold attacking the Stomach,and Stomach Qi deficiency,the Chong Qi generally can′t go down,so it is often accompanied by Stomach Qi reversing.Wuzhuyu Decoction can be used to treat it by warming the Middle Jiao,dispelling Cold and lowering the reversed Qi,which can be used to test Chen Xiuyuan′s opinion of"taking Yangming to solve Chong Meridian problem".Therefore,it is clear why Wuzhuyu Decoction can be applied to treat diseases of Yangming,Shaoyin and Jueyin.

关 键 词：吴茱萸汤 吴茱萸汤方证 “冲脉不治 取之阳明” 厥阴经 冲胃气逆 《伤寒论》 

分 类 号：R222.16[医药卫生—中医基础理论]