《金匮要略》“百脉一宗”释义探析  

Analysis of Bai Mai Yi Zong in Jin Gui Yao Lue

作　　者：刘晖 刘紫阳[1] 崔姗姗[1] LIU Hui;LIU Ziyang;CUI Shanshan(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2024年第9期1852-1855,共4页Acta Chinese Medicine

基　　金：河南省高等教育教学研究项目(2021SJGLX170);河南中医药大学2022年中医基础类课程虚拟教研室建设项目;河南中医药大学教育教学改革研究与实践立项项目(2024JX70)。

摘　　要：《金匮要略》中百合病是临床比较常见、又较易误诊的疾病,其关键在于对“百脉一宗,悉致其病也”这一病机的理解。关于“一宗”,历代医家有不同解释,如“心”“心主”“肺”“宗气”“合而为一”“不分经络”等。笔者从文理、义理、医理、临床实践、用药等多方面对百合病进行分析,认为“一宗”当指“宗气”。近现代,百合地黄汤、百合知母汤、百合鸡子黄汤、百合滑石汤等百合诸方也常被应用于治疗抑郁症、焦虑症、癔症、神经症或亚健康状态等。患者本无五脏六腑器质性病变,多是体内气、血、津液运行输布失常,百脉不和所致。而百脉的运行必须依赖气的推动与调和,宗气是后天重要之气,宗气不利等因素是百合类疾病的重要病因之一,有针对性地选用百合诸方,对提高百合类诸病的临床疗效和拓展经典方剂的应用具有深远的意义。Baihe disease is a common and easily misdiagnosed disease in clinical practice in Jin Gui Yao Lue,and the key lies in the understanding of the pathogenesis of"Bai Mai Yi Zong,each of which causes various diseased".Regarding"Yi Zong",the doctors of all generations have different interpretations,such as"Heart","Heart the master","Lung","Zongqi","unity into one","regardless of meridians"and so on.The author analyzes Baihe disease from different perspective,such as literal meaning,philosophical connotation,medical connotation,clinical practice and medication,and believes that"Yi Zong"should refer to"Zong Qi".In modern times,Prescriptions for Baihe disease,such as Baihe Dihuang Decoction,Baihe Zhimu Decoction,Baihe Jizihuang Decoction and Baihe Huashi Decoction,are often used to treat depression,anxiety,hysteria,neurosis or sub-health conditions.Patients have no organic lesions in the Five Zang or Six Fu,which were mostly caused by the abnormal flow and distribution of Qi,blood and Fluid in the body as well as the disharmony of Bai Mai.The operation of Bai Mai must rely on the promotion and harmony of Qi.Zong Qi is the important acquired Qi of human,and disfunction of Zong Qi is one of the important causes of Baihe diseases.

关 键 词：“百脉一宗” 百合病 宗气 百合地黄汤 百合知母汤 百合鸡子黄汤 百合滑石汤 《金匮要略》 张仲景 

分 类 号：R222.3[医药卫生—中医基础理论]