张仲景对《黄帝内经》脾胃理论的发挥  

Zhang Zhongjing′s Development of the Spleen-Stomach Theory from Huangdi′s Internal Classic

作　　者：杨文园 何晓晖[2] YANG Wenyuan;HE Xiaohui(Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine,Nanchang,Jiangxi,China,330006;Jiangxi University of Chinese Medicine,Nanchang,Jiangxi,China,330004)

机构地区：[1]江西省中西医结合医院,江西南昌330006 [2]江西中医药大学,江西南昌330004

出　　处：《河南中医》2024年第11期1632-1635,共4页Henan Traditional Chinese Medicine

摘　　要：《伤寒论》继承了《黄帝内经》“人以胃气为本”“土生万物”思想,将顾护脾胃的思想贯穿于治疗疾病始终,在六经证治中既重视脾胃阳气又重视脾胃阴液。治疗太阳病时,强调发汗过程中要资养汗源;素体脾胃虚弱者,托邪外出同时补中和胃;使用峻药攻邪时,以攻邪不伤正为原则,处处顾护脾胃之气;太阴病脾阳虚弱者,提出温之的治疗法则,方用理中汤、四逆汤。其将《黄帝内经》脾胃升降理论具体运用于脾胃病的施治中,以辛开苦降,降逆调和为法,设立了以半夏泻心汤为首的诸泻心汤方,开创了以辛开苦降法治疗寒热交错、气机痞塞之脾胃病先河;在药物的煎法、服法及药后调护中也处处注意养护胃气。Treatise on Cold Damage and Miscellaneous Diseases inherits the ideas from Huangdi′s Internal Classic,including the concepts of"the stomach qi as the root of life"and"the earth generating all things."Zhang Zhongjing consistently emphasized the regulation and protection of the spleen and stomach throughout the whole process of disease treatment.In the six-meridian pattern identification and treatment,he placed equal importance on both the yang qi and yin fluid of the spleen and stomach,always emphasizing the protection of stomach qi.When treating greater yang diseases,Zhang Zhongjing stressed nourishing the source of sweat during diaphoresis.For those with a constitutionally weak spleen and stomach,he would simultaneously expel the pathogens while supplementing the middle energizer and harmonizing the stomach.When using strong medications to expel pathogens,he adhered to the principle of eliminating pathogens without damaging healthy qi,consistently protecting the spleen and stomach qi.For greater yin diseases with spleen yang deficiency,he proposed the method of warming therapy,using formulas like Center-Regulating Pill,and Frigid Extremities Decoction.He applied the ascending and descending theory of the spleen and stomach from Huangdi′s Internal Classic to the treatment of spleen and stomach disorders,emphasizing the method of pungent opening and bitter descending to suppress upward perversion of qi and harmonize the stomach,and established a series of heart-draining formulas like Pinellia Heart-Draining Decoction,which became a model for treating spleen and stomach diseases characterized by a mixture of cold and heat,and qi stagnation using the pungent opening and bitter descending method.His approach was also reflected in the methods of decocting,administering,and post-treatment care,ensuring the nourishment of stomach qi at every step.

关 键 词：脾胃理论 《黄帝内经》 《伤寒杂病论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]