表阴证的辨治探析  

An analysis of the differentiation and treatment of exterior Yin syndrome

作　　者：丁红平 奚胜艳[2] DING Hongping

机构地区：[1]武汉市洪山区中医医院,湖北武汉430070 [2]厦门大学医学院,福建厦门361102

出　　处：《中医临床研究》2023年第29期46-49,共4页Clinical Journal Of Chinese Medicine

基　　金：福建省自然科学基金面上项目(2018J01136)。

摘　　要：表阴证是病位在表、病性属阴的一类证候,在当前临床上并不少见,然而容易被医家忽视或误诊为表阳证或表阳里阴合病,其根本原因在于表阴证的诊断标准不明。中医讲“表”是指体表,即皮肤、肌肉、筋骨等所组成的机体外在躯壳。病位与病性密不可分,病位分为表、里、半表半里三个病位,每个病位均有或阴或阳的两种病性反应。在“表”的病位上出现阳性病证,称为表阳证;呈现阴性病证,称为表阴证。表阴证因其特殊性,往往易被忽视或误诊误治,导致疗效不佳或引发疾病传变。少阴病提纲仅仅反映少阴病属于阴证,不足以诊断表阴证。表阴证的诊断标准是机体存在表证,同时具有脉象沉取细弱无力等沉衰性的阴性症状反应。表阴证由表证与阴证有机组成,对表阴证的诊断可从两个维度进行,一是识别有无表证,二是辨认阴阳病性。既有表证,又是阴证,那么可诊断为表阴证。辨识表证须紧密联系太阳病。太阳病是病位在表的阳性病证,表阴证是病位在表的阴性病证,二者的病性虽相反,但病位是相同的,体表上的症状反应几乎是一致的。张机(字仲景)对表阴证的治法是温阳解表,对表阴证兼痰饮水湿或里热,经常需要一并治疗。文章认为,当今的表阴证多发于阴证之体,为了将病证与体质一并调治,提出将单纯表阴证视为表阴里阴同病来论治的学术观点。Exterior Yin syndrome(表阴证)is a kind of syndrome with the disease position of Yin on the surface of the body,which is not uncommon in the current clinical practice.However,it is easy to be ignored or misdiagnosed by doctors as exterior Yang syndrome(表阳证)or exterior Yang and interior Yin syndrome(表阳内阴证).The basic reason is that the diagnosticE standard of the exterior Yin syndrome is unclear.In TCM,Biao(表)refers to the exterior body,which is composed of skin,muscles,and bones.The disease nature is closely related to the disease location.There are three disease locations:exterior,interior,half exterior and half interior.Each disease location has two kinds of pathological reactions,either Yin or Yang.The appearance of Yang disease syndrome on the exterior is called the exterior Yang syndrome,and the appearance of Yin disease syndrome is called the exterior Yin syndrome.Because of its particularity,exterior Yin syndrome is often neglected or misdiagnosed and mistreated,resulting in poor efficacy.The outline of Shaoyin(少阴)disease can only reflect that the Shaoyin disease belongs to Yin syndrome,which is not enough to diagnose exterior Yin Syndrome.The diagnostic criterion of exterior Yin syndrome is that the body has exterior syndrome,and has the symptoms of depression such as weak pulse.The exterior Yin syndrome is composed of exterior syndrome and Yin syndrome.The diagnosis of exterior Yin syndrome can be carried out from two dimensions,one is to identify whether there is exterior syndrome,and the other is to identify the nature of Yin and Yang diseases.If there is both exterior syndrome and Yin syndrome,it can be diagnosed as exterior Yin syndrome.Identification of exterior Yin syndrome needs to be distinguished from Taiyang disease(太阳证).Taiyang disease is a Yang disease with the location on the exterior,but exterior Yin syndrome is a Yin disease with the location on the surface.Although the disease nature of the two is opposite,the disease location is the same,and the symptoms and

关 键 词：表阴证 《伤寒论》 少阴病 辨证论治 

分 类 号：R241[医药卫生—中医诊断学]