脏结证治源流探析  

Probe into the origin and development of treatment of zang jie syndrome

作　　者：崔家祥 白晨志 张瑞祥 孙凤一 王洪海 CUI Jiaxiang;BAI Chenzhi;ZHANG Ruixiang;SUN Fengyi;WANG Honghai(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学中医学院,济南250355

出　　处：《中华中医药杂志》2024年第6期2796-2800,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：山东省研究生教育质量提升项目(No.SDYAL19145)。

摘　　要：考据文献发现,脏结是一个涉及杂病、温病范畴的复杂概念,其基于“结者缔也”的本义,与《伤寒论》脏结理论联系密切。其发生发展是由表入里、由轻到重的动态连续过程,寒邪为患、阳气持续衰弱为本病的主要矛盾,同时湿邪、热邪也可作为次要矛盾出现,其病机有表邪内陷、阳衰寒凝、寒热格拒等。在治疗上,金元医家重视解表散邪,多选用小柴胡汤加生姜并灸刺关元穴,明清以降,温阳散结成为治疗的主流,脏结外治法进一步发展,和解寒热、随证处方及预防为先等治法也开始出现。同时,随着医家对胁下痞痛症候的日渐重视,明清以后杂病脏结开始成为《伤寒论》脏结体系的重要部分。According to the literature,it is found that zang jie syndrome is a complex concept involving miscellaneous diseases and febrile diseases,which is closely related to the zang jie syndrome theory in Treatise on Febrile Diseases.Its occurrence and development is a dynamic and continuous process from exterior to interior,from light to heavy.The main contradiction of the disease is the cold evil,and the continuous decline of yang qi.At the same time,the damp evil and heat evil can also appear as secondary contradictions.Its pathogenesis includes the invagination of exterior evil,the decline of yang and the cold coagulation,and the rejection of cold and heat.In terms of treatment,doctors in the Jin and Yuan dynasties paid attention to relieving exterior diseases and dispelling evils.They mostly used Xiaochaihu Decoction plus ginger and moxibustion at Guanyuan(CV4).Since the Ming and Qing dynasties,warming the yang and dispersing the knot has become the mainstream of treatment.External treatment of dirty knots has further developed,and treatment methods such as reconciling cold and heat,taking prescriptions with symptoms and taking prevention as the first have also begun to appear.At the same time,with the increasing attention paid by doctors to the syndrome of abdominal pain under the hypochondriac region,the miscellaneous diseases and visceral knots began to become an important part of the visceral knot system in Treatise on Febrile Diseases after the Ming and Qing Dynasties.

关 键 词：脏结 五脏 《伤寒论》 温阳散寒 和解寒热 内伤杂病 

分 类 号：R228[医药卫生—中医基础理论]