基于《伤寒杂病论》蓄血理论探讨“独藏瘀毒”的理论内涵  

Discussion on the theoretical connotation of‘single or unusual clinical manifestation indicating blood stasis with toxin'based on the theory of blood storage in Shanghan Zabing Lun

作　　者：蔡妍 白星 柯雅妮 徐超 陈滨海 姜涛 戴立思 张光霁[1,2,3] CAI Yan;BAI Xingg;KE Yani;XU Chao;HEN Binhai;JIANG Tao;DAI Lisi;ZHANG Guangji(School of Basic Medical Sciences,Zhejiang Chinese Medical University,Hangzhou 310053,China;Zhejiang Key Labortary of Blood-Stasis-Toxin Syndrome,Zhejiang Chinese Medical University,Hangzhou 310053,China;Traditional Chinese Medicine‘Preventing Disease’Wisdom Health Project Research Center of Zhejiang Province,Hangzhou 310053,China;The Second Affliated Hospital of Zhejiang Chinese Medical University(Xinhua Hospital of Zhejiang Province),Hangzhou 310005,China)

机构地区：[1]浙江中医药大学基础医学院,杭州310053 [2]全省中医“瘀毒”证重点实验室,杭州310053 [3]中医“治未病”智慧健康浙江省工程研究中心,杭州310053 [4]浙江中医药大学附属第二医院(浙江省新华医院),杭州310005

出　　处：《中华中医药杂志》2024年第8期3910-3914,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金重点项目(No.82030119);国家重点研发计划(No.2019YFC1708700,No.2019YFC1708702)。

摘　　要：从《伤寒杂病论》蓄血理论探求“独藏瘀毒”理论的内涵,启发临床治疗。文章从《伤寒杂病论》的蓄血理论出发,探寻“瘀毒”与“独处藏奸”、蓄血理论间联系,挖掘“独藏瘀毒”的理论内涵,并结合《伤寒杂病论》中运用蓄血理论和“独处藏奸”辨证论治的相关论述,阐释“独藏瘀毒”临床意义。从蓄血理论与瘀毒理论出发,发现瘀毒发病的前提是蓄血,而蓄血临证多有“独处”,这与瘀毒发病时的临床表现具有相似性,提出“独藏瘀毒”理论,进而结合《伤寒杂病论》中运用“独处藏奸”和蓄血理论辨证论治的相关论述,细致分析大黄?虫丸、鳖甲煎丸、抵当汤、下瘀血汤中反常的脉症及其反映的病机与相应治疗,为后世“瘀毒藏奸”所致疾病的治疗提供思路。当出现病证难以明确、辨证不易统一的情况时,需要着重关注独处是否存在“独藏瘀毒”,为疾病治疗之关键,明辨审慎“独藏瘀毒”理论,对临床正确诊治大有裨益。To explore the connotation of the theory of'single or unusual clinical manifestation indicating blood stasis with toxin'from the theory of blood storage in Shanghan Zabing Lun,so as to enlighten clinical treatment.Based on the theory of blood storage in Shanghan Zabing Lun,this paper explores the relationship between the connotation of'blood stasis with toxin'and the theory of'single or unusual clinical manifestation indicating root causes'with the theory of blood storage,and excavates the theoretical connotation of'single or unusual clinical manifestation indicating blood stasis with toxin'.Combined with the relevant discussion on the application of the theory of blood storage and syndrome differentiation and treatment of'single or unusual clinical manifestation indicating root causes'in Shanghan Zabing Lun,the clinical significance of'single or unusual clinical manifestation indicating blood stasis with toxin'is explained.Based on the theory of blood storage and the connotation of'blood stasis with toxin',it is found that the premise of the pathogenesis of blood stasis with toxin is blood storage,and most of the clinical symptoms of blood stasis with toxin are'single or unusual',which is similar to the clinical manifestation of blood stasis with toxin,and puts forward the theory of'single or unusual clinical manifestation indicating blood stasis with toxin'.Then combined with the relevant discussion on the syndrome differentiation and treatment of'single or unusual clinical manifestation indicating root causes'and the theory of blood storage in Shanghan Zabing Lun.The abnormal pulse symptoms and their pathogenesis and corresponding treatment in Dahuang Zhechong Pills,Biejiajian Pills,Didang Decoction and Xiayuxue Decoction are analyzed in detail,so as to provide ideas for the treatment of diseases caused by'single or unusual clinical manifestation indicating blood stasis with toxin'in later generations.When the disease syndrome is difficult to be clear and syndrome differentiation is difficult to unify,it is ne

关 键 词：独藏瘀毒 蓄血 蓄血理论 瘀毒理论 独处藏奸 《伤寒杂病论》 

分 类 号：R24[医药卫生—中医临床基础]