从“太阳蓄血”病位探析到“小肠血证”的辨证论治思考  

Thoughts on the Syndrome Differentiation and Treatment of"Small Intestine Blood Syndrome"from the Analysis of the Disease Location of"Blood Accumulation in the Taiyang"

作　　者：邵天赐 杜佳蓉 李楠[1] 杨懿 陈智慧[1] 张会永[2] SHAO Tianci;DU Jiarong;LI Nan;YANG Yi;CHEN Zhihui;ZHANG Huiyong(Liaoning University of Traditional Chinese Medicine,Shenang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Chinese Medicine,Shenang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中西医结合慢性病杂志》2024年第1期58-62,共5页JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE ON CHRONIC DISEASES

基　　金：辽宁省自然科学基金创新能力提升计划项目(2022-NLTS-13-05);沈阳市中青年科技创新人才培育专项(RC230077)。

摘　　要：“太阳蓄血”是《伤寒论》重要概念之一,治疗蓄血的代表方剂“桃核承气汤”亦被国家药监局和中医药管理局印发的《古代经典名方目录》收录。然而历代医家对“太阳蓄血”病位认识不尽相同,使得后世学者难以窥其堂奥,又因其原文描述使其病证成为“疑案”,故而致使蓄血三方束之高阁,鲜为应用。基于“太阳蓄血”的证候表现和《黄帝内经》的理论体系进行分析,参阅相关古籍,以证明“太阳蓄血”即为“小肠蓄血”,阐述蓄血病位在小肠腑的依据。进而思考现有中医理论中可能对小肠辨证的缺失,希望以此能为《伤寒论》的理论研究和临床应用以及中医基础理论的丰富提供更多参考。"Blood accumulation in the Taiyang"is one of the important concepts in Treatise on Febrile Diseases.The representative prescription for treating blood accumulation,"Taohe Chengqi Decoction(桃核承气汤)",is also included in the Catalog of Ancient Classical Famous Prescriptions issued by the National Medical Products Administration and the State Administration of Traditional Chinese Medicine.However,physicians in different dynasties have different understandings of the disease location of"blood accumulation in the Taiyang",making it difficult for later scholars to fully understand its profound meaning.Moreover,due to the original text description,its syndrome and disease become a"mystery case".As a result,the three prescriptions for blood accumulation are left unused.Based on the syndrome manifestations of"blood accumulation in the Taiyang"and the theoretical system of Yellow Emperor's Inner Canon,and referring to relevant ancient books,this article aims to prove that"blood accumulation in the Taiyang"is"blood accumulation in the small intestine",and expounds the basis for the disease location of blood accumulation in the small intestine.Furthermore,it reflects on the possible lack of syndrome differentiation of the small intestine in the existing traditional Chinese medicine theory,hoping to provide more references for the theoretical research and clinical application of Treatise on Febrile Diseases and the enrichment of the basic theory of traditional Chinese medicine.

关 键 词：蓄血证 《伤寒论》 小肠 小肠血证 桃核承气汤 抵当汤 

分 类 号：R255.7[医药卫生—中医内科学] R574.5[医药卫生—中医学]