基于经方与吴氏扶阳理论从少阳、少阴枢机辨治呕吐  

Diagnosis and Treatment of Vomiting from Shaoyang and Shaoyin Cardinal Mechanisms Based on Classic Prescriptions and Wu's Theory of Supporting Yang

作　　者：许云姣 商洪涛[2] 吴文笛[1] 姜莉云[1] 袁红霞[3] XU Yunjiao;SHANG Hongtao;WU Wendi;JIANG Liyun;YUAN Hongxia(Kunming Municipal of Traditional Chinese Medicine,Kunming 650500,China;Nanjing University of Traditional Chinese Medicine,First Clinical Medical College,Nanjing 210023,China;Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]昆明市中医医院,云南昆明650500 [2]南京中医药大学,江苏南京210023 [3]天津中医药大学,天津300193

出　　处：《云南中医药大学学报》2024年第5期11-15,共5页Journal of Yunnan University of Chinese Medicine

基　　金：国家自然科学基金-地区科学基金项目(82260919);云南省科学技术厅-中医联合专项重点项目(202101AZ070001-007);云南省中医药学科高层次后备人才项目。

摘　　要：《素问·阴阳应象大论》中指出“善诊者,察色按脉,先别阴阳”,熟读仲景《伤寒论》《金匮要略》原文可发现伤寒六经及各脏腑病证皆可出现呕吐,治疗可谓八法兼备,然吴氏扶阳学术流派认为,阴阳是辨证之总纲,纵观仲景六经辨治呕吐诸方,整体上仍首分阴阳,因六经辨证是阴阳辨证的具体体现。三阴三阳“开阖枢”乃六经的灵魂,是六经辨证的精髓,其中枢机是开阖枢关键,对开阖具有主导作用,故仲景治呕八法之中尤重和机枢调法,或从少阳枢机枢转太阳、阳明,或从少阴枢转太阴、厥阴。临床辨治呕吐应遵循仲景抓主症,审证求因,从因论治,也应重视少阳、少阴之“枢机”。In the"Su Wen·Yin Yang Ying Xiang Da Lun",it is pointed out that"those who are good at diagnosis should observe the color and pulse,and first distinguish between Yin and Yang."After reading the original texts of Zhong jing's"Treatise on Cold Damage"and"Essential Synopsis of the Golden Chamber",it can be found that vomiting can occur in the six meridians of cold damage and various organ diseases,and the treatment can be described as having eight methods simultaneously.However,the Wu’s Fu Yang Academic School believes that Yin and Yang are the general principles of syndrome differentiation.Throughout the various formulas for treating vomiting in the six meridians of Zhong Jing,Yin and Yang are still the first to be distinguished,because the differentiation of the six meridians is a specific manifestation of Yin and Yang differentiation.The"opening and closing pivot"of the three Yin and three Yang meridians is the soul of the six meridians and the essence of syndrome differentiation.Among them,the pivot mechanism is the key to opening and closing,and has a dominant role in opening and closing.Therefore,among the eight methods of treating nausea and vomiting in Zhongjing,the emphasis is particularly on the adjustment of the pivot mechanism,either from the Shaoyang pivot to the Taiyang and Yangming,or from the Shaoyin pivot to the Taiyin and Jueyin.Clinical diagnosis and treatment of vomiting should follow the principle of identifying the main symptoms,identifying the causes through examination,and treating based on the causes.It is also important to pay attention to the"pivot"of Shaoyang and Shaoyin.

关 键 词：《伤寒论》 经方 呕吐论治 开阖枢 

分 类 号：R222[医药卫生—中医基础理论]