“攻所得”应用探析  

Analysis on Application of“Attacking the Combination”

作　　者：谢琴琴 吕翠霞 邵状 李岩松 刘朋 XIE Qinqin;LYU Cuixia;SHAO Zhuang;LI Yansong;LIU Peng(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,250355 Jinan,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355

出　　处：《山东中医杂志》2024年第11期1213-1218,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省名老中医药专家传承工作室建设项目(编号:2018-5)。

摘　　要：“攻所得”出自《金匮要略·脏腑经络先后病》“夫诸病在脏,欲攻之,当随其所得而攻之”,是张仲景提出的一条重要的治疗原则。本文通过对原文的解读,结合《伤寒论》和《金匮要略》的相关条文,认为“攻所得”是基于复合病机下的一种别于常法的治疗手段,通过祛除“所得”之邪不仅可祛除无形之寒邪、热邪、暑邪、风邪、疟邪等,还可祛除痰湿、血瘀等有形之邪,且能达到补虚的目的,属审因论治范畴,是由所得之邪在病机中的主导作用所决定的。“攻所得”法不仅是对治疗主次的把握,也是对治疗先后的把控,对于临床上疑难杂症的诊治具有深刻的借鉴意义。As a significant therapeutic guideline,“Attacking the combination”originates from the Synopsis of the Golden Chamber:Early and Later Diseases of Zang-Fu Organs and Meridians,where ZHANG Zhongjing states:“For all diseases located in the viscera,if one wishes to attack them,the treatment should be directed at the combination”.Through an analysis of the original text,combined with relevant passages from both the Treatise on Cold Damage Diseases and the Synopsis of the Golden Chamber,this study suggests that“attacking the combination”represents a treatment approach distinct from conventional methods,which addresses complex disease mechanisms.By eliminating the combined evil qi,not only can one dispel intangible evil qi such as cold,heat,summer heat,wind,and malaria,but also tangible evil qi like phlegm-dampness and blood stasis.Furthermore,this approach can achieve the goal of replenishing deficiencies,falling within the scope of treatment based on cause differentiation.The application of the“attacking the combination”is determined by the predominant role of the combined evil qi within the disease mechanism.This method not only involves discerning the primary and secondary aspects of treatment but also provides control over the sequence of interventions,offering profound insights for the diagnosis and management of complex and refractory diseases in clinical practice.

关 键 词：攻所得 《金匮要略》 审因论治 潜在病机 复合病机 

分 类 号：R222[医药卫生—中医基础理论]