从六经的病传病解法度探讨《金匮要略》湿病及其病传之病机证治  

Exploration on the Pathogenesis and Syndrome Differentiation and Treatment of Dampness Syndrome and Its Evolution Recorded in the Synopsis of the Golden Chamber Based on the Law of Six-Meridian Disease Evolution and Resolution

作　　者：张晓轩 刘畅 黄诗雅 老膺荣 许家栋 林树元[3] 杨志敏 ZHANG Xiao-Xuan;LIU Chang;HUANG Shi-Ya;LAO Ying-Rong;XU Jia-Dong;LIN Shu-Yuan;YANG Zhi-Min(State Key Laboratory of Dampness Syndrome of Traditional Chinese Medicine,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;School of Basic Medical Sciences,Zhejiang Chinese Medical University,Hangzhou 310053 Zhejiang,China)

机构地区：[1]省部共建中医湿证国家重点实验室,广州中医药大学第二附属医院,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405 [3]浙江中医药大学基础医学院,浙江杭州310053

出　　处：《广州中医药大学学报》2023年第8期2080-2084,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：省部共建中医湿证国家重点实验室专项(编号:SZ2021ZZ01,SZ2021ZZ31);中医经典岭南临证解析整合课题建设项目(广中医校办[2022]97号)。

摘　　要：基于六经的病传病解法度,探讨《金匮要略》记载的湿病及其病传的病机证治。认为《金匮要略》中的三阳湿病病机为湿邪侵犯、困束肌表,三阴湿病病机为胃气亏虚、湿邪袭表,治疗湿病在表的总则为“微发其汗”。三阳湿病的治疗,太阳寒湿病可予麻黄加术汤,阳明湿病可予一物瓜蒂汤,太阳阳明湿病可予麻黄杏仁薏苡甘草汤,少阳湿病可予柴胡加白术防风汤;三阴湿病的治疗,太阴湿病可予防己黄芪汤,少阴湿病可视风邪与湿邪的轻重而予桂枝附子汤、白术附子汤、甘草附子汤,厥阴湿病可予乌梅苓桂术甘汤。湿病病传可致黄疸、肾着、历节,可分别予麻黄连轺赤小豆汤、甘草干姜茯苓白术汤、桂枝芍药知母汤(风湿历节)、乌头汤(寒湿历节)。This paper discussed the pathogenesis as well as the syndrome differentiation and treatment of dampness syndrome and its evolution recorded in the Synopsis of the Golden Chamber based on the law of sixmeridian disease evolution and resolution.It is believed that the pathogenesis of triple-yang dampness syndrome in the Synopsis of the Golden Chamber is due to the pathogenic dampness attacking and trapping the muscular striae and exterior,while the pathogenesis of triple-yin dampness syndrome is due to the insufficiency of stomach qi and pathogenic dampness attacking the exterior.The therapeutic principle for dampness syndrome in the exterior is to induce diaphoresis slightly.For the triple-yang dampness syndrome,the taiyang cold-damp syndrome can be treated with Mahuang Plus Zhu Decoction,the yangming dampness syndrome can be treated with Yiwu Guadi Decoction,the taiyang yangming dampness syndrome can be treated with Mahuang Xingren Yiyi Gancao Decoction,the shaoyang dampness syndrome can be treated with Chaihu Plus Baizhu Fangfeng Decoction.For the triple-yin dampness syndrome,the taiyin dampness syndrome can be treated with Fangji Huangqi Decoction,the shaoyin dampness syndrome can be treated with Guizhi Fuzi Deocoction,Baizhu Fuzi Deocoction or Gancao Fuzi Deocoction depending on the predominance of the pathogenic wind or pathogenic dampness,and the jueyin dampness syndrome can be treated with Wumei Ling Gui Zhu Gan Decoction.The dampness syndrome may develop into jaundice,nephrosis and arthralgia,which can be treated with Mahuang Lianyiao Chixiaodou Decoction,Gancao Ganjiang Fuling Baizhu Decoction,Guizhi Shaoyao Zhimu Decoction(indicated for wind-damp arthralgia)and Wutou Decoction(indicated for cold-damp arthralgia)respectively.

关 键 词：湿病 六经 三阳湿病 三阴湿病 病机 病传法度 病解法度 经方 《金匮要略》 

分 类 号：R222.33[医药卫生—中医基础理论]