《金匮要略》“郁冒”病证探究  

Exploration of"Yu Mao"in the Synopsis of the Golden Chamber

作　　者：钟文霞 殷鸣[1] 张琦[1] ZHONG Wenxia;YIN Ming;ZHANG Qi(Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)

机构地区：[1]成都中医药大学,成都611137

出　　处：《中国中医基础医学杂志》2024年第11期1809-1812,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金项目(81873222);中国博士后科学基金项目(2023MD744130);四川省哲学社会科学重点研究基地项目(SC23E074)。

摘　　要：郁冒是《金匮要略》产后三病之一,亦作症状出现于《伤寒论》厥病、厥阴病中,古今医家对其内涵认识不一。本文从文字学、文献溯源、以方测证三种角度对其内涵进行研究,认为“郁冒”二字本意是由闭郁所造成的昏冒症状。《黄帝内经》将郁冒内应于心,指神志异常,《伤寒论》中郁冒作为症状,指神昏、晕厥、郁闷等神志症状,为广义郁冒。《金匮要略》则将郁冒作为女性产后常见病,病因为“亡血复汗、寒多”,在产后津血亏虚情况下,邪气闭郁,阴阳不交,出现神志症状,以小柴胡汤为主方,为狭义郁冒。狭义郁冒与现代产褥期抑郁相吻合,女性经期、更年期生理特点与产褥期类似,亦常出现郁冒症状,这些疾病均可参照郁冒病治疗。Yu Mao is one of the three postpartum diseases in the Synopsis of the Golden Chamber.It also appears as a symptom in the Jue disease and Jue Yin disease in Treatise on Febrile Diseases.The understanding of its connotation by ancient and modern doctors is inconsistent.This paper researches its connotation from three perspectives:literalism,literature tracing,and evidence testing by prescription,and concludes that the word"Yu Mao"originally meant the symptom of faintness caused by shutting up and depression.It refers to the abnormal mental state in the Inner Canon of Huangdi and is located in the heart.In the Treatise on Febrile Diseases,Yu Mao is regarded as a symptom,which refers to fainting,depression,and other symptoms of the mind,which is a broad definition of Yu Mao.In the Synopsis of the Golden Chamber,Yu Mao is regarded as a common postpartum disease of women,which is caused by the"loss of blood,sweating,and excessive cold",and in the postpartum period when there is a deficiency of blood and fluid,due to that there is a lack of communication between Yin and Yang and the closure of evil Qi,the emergence of mental symptoms.Xiaochaihu decoction is the main formula.This is a narrow sense of Yu Mao.The narrow sense of Yu Mao coincides with modern puerperal depression.The physiological characteristics of women's menstrual and menopausal periods are similar to those of the postpartum period,and depression symptoms are often present.These diseases can be treated according to Yu Mao.

关 键 词：《金匮要略》 郁冒 产褥期抑郁 小柴胡汤 

分 类 号：R222[医药卫生—中医基础理论]