探析卫气营血理论在内伤杂病诊疗中的应用  

Application of Defense-Qi-Nutrient-Blood Theory in the Diagnosis and Treatment of Internal Diseases

作　　者：李阑 徐大基 LI Lan;XU Daji(Pok Oi Hospital-The Chinese University of Hong Kong Chinese Medicine Clinic cum Teaching and Research Center,Hong Kong 999077,China;Hong Kong Evidence-Based Chinese Medicine Centre,Hong Kong 999077,China)

机构地区：[1]博爱医院-香港中文大学中医诊所暨教研中心,中国香港特别行政区999077 [2]香港中医循证诊疗及康复中心,中国香港特别行政区999077

出　　处：《基层中医药》2024年第7期59-63,共5页Basic Traditional Chinese Medicine

摘　　要：叶桂卫气营血辨证在外感疾病中广泛应用,本文欲探析卫气营血辨证在内伤杂病中的诊疗应用规律。本文基于叶桂经典条文“在卫汗之可也,到气才可清气,入营尤可透热转气,……入血尤恐耗血动血,直须凉血止血”,探析其理论在内伤杂病的应用。叶氏提出“卫之后方言气,营之后方言血”这一核心理论,高度概括温病发展过程中的传变规律是由卫而到气到营到血的传变次第。卫气营血辨证理论长于辨疾病病位深浅及病情轻重,对温病的辨病提供了纲领性的指导,同样为杂病的辨证诊治提供了新的思路,但将复杂疾病按照传统的卫气营血辨证理论分型显然不够详细,确定疾病病变部位和脏腑过于笼统,对病情的划分仍然有一定的局限性,若将卫气营血辨证与其他辨证理论相互结合,能够更全面准确地诊疗杂病。Defense-qi-nutrient-blood syndrome differentiation proposed by Ye Gui is widely used in exogenous diseases.This article intended to explore the application rules of defense-qi-nutrientblood syndrome differentiation in the diagnosis and treatment of internal diseases.Based on the classic statement of Ye Gui that"Sweating method can be used in defense aspect syndrome,clearing qi is suitable for the qi aspect,penetrating heat to transform qi at the nutrient level,…at the blood aspect,it should be cautious of consuming and moving the blood,directly cooling the blood and stopping bleeding",this article overviewed the application of this theory in internal diseases.Ye Gui put forward the core theory of"qi after defense,blood after nutrient",which succinctly summarized the transmission law of warm diseases as progressing from defense to qi,then to nutrient,and finally to blood.Defense-qi-nutrient-blood syndrome differentiation theory excels in distinguishing the depth and severity of diseases,providing programmatic guidance for warm diseases,and offering new ideas for the diagnosis and treatment of miscellaneous diseases.However,applying the traditional defenseqi-nutrient-blood syndrome differentiation theory to complex diseases is not sufficiently detailed.It is too general in determining the disease lesions and viscera,and the division of the condition still has certain limitations.If defense-qi-nutrient-blood syndrome differentiation is combined with other syndrome differentiation theories,miscellaneous diseases can be diagnosed and treated more comprehensively and accurately.

关 键 词：卫气营血辨证 内伤杂病 叶桂 

分 类 号：R24[医药卫生—中医临床基础]