张仲景脾胃学说思想内涵及特色探析  

Analysis of the concept and characteristics of ZHANG Zhongjing’s spleen and stomach theory

作　　者：陈晶晶 张念志[2] 韩明向[2] 王娇娇 CHEN Jingjing;ZHANG Nianzhi;HAN Mingxiang;WANG Jiaojiao(Respiratory and Critical Care Medicine Department,Shanxi Provincial Chinese Medicine Hospital,Taiyuan,Shanxi,030012,China;Department of Respiratory Medicine,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui,230031,China;Graduate School,Anhui University of Chinese Medicine,Hefei,Anhui,230038,China)

机构地区：[1]山西省中医院呼吸与危重症医学科,山西太原030012 [2]安徽中医药大学第一附属医院呼吸内科,安徽合肥230031 [3]安徽中医药大学研究生院,安徽合肥230038

出　　处：《甘肃中医药大学学报》2024年第6期22-26,共5页Journal of Gansu University of Chinese Medicine

基　　金：国家重大疑难疾病临床防治中心建设项目(国中药函2014NO.146);国家自然科学基金面上项目(81774301,82174312);山西省高等学校科技成果转化培育项目(202003D31013/GZ);山西省中医药管理局科研项目(2023ZYYC013);山西省自然科学基金面上项目(202203021211048);山西省中医药研究院院级课题(202219)。

摘　　要：通过对《黄帝内经》《伤寒论》《金匮要略》等著作及重要文献进行检索、研读,对张仲景的脾胃学说思想内涵及特色进行归纳、总结。张仲景脾胃学说思想内容丰富,涉及领域广泛。脾胃与六经病病因病机的关系:太阳病,脾胃虚弱、营卫不和;阳明病,邪入阳明、胃燥津伤;少阳病,脾胃受损、血弱气尽;太阴病,脾胃阳虚、寒湿内盛;少阴病,脾肾阳虚、少阴寒化;厥阴病,脾虚肝郁、土被木伐。治则治法方面,张仲景主张以补法为主,温补脾胃阳气;以泻下为辅,给予邪气出路;注重寒热兼施,重视标本缓急。此外,其在辨证施治、处方用药及“治未病”等方面均有“顾护脾胃”思想的体现。张仲景脾胃学说思想对于指导疾病诊疗具有重要的参考价值,值得临床医生借鉴与深入研究。By searching and studying important works such as“Huangd's Canon of Internal Medicine”,“Treatise on Febrile Diseases”and“Synopsis of Prescriptions of the Golden Chamber”,the ideological connotations and characteristics of ZHANG Zhongjing's theory on the spleen and stomach have been summarized.ZHANG Zhongjing's theory is rich in content and covers a wide range of fields.The relationship between the spleen and stomach and the etiology and pathogenesis of diseases of the six meridians:for Taiyang disease,it is due to spleen and stomach weakness and disharmony of the nutritive and defensive qi;for Yangming disease,it is because pathogens enter the Yangming and the stomach becomes dry and the body fluids are damaged;for Shaoyang disease,it is due to impairment of the spleen and stomach and depletion of blood and qi;for Taiyin disease,it is because the spleen and stomach yang is deficient and cold-dampness prevails internally;for Shaoyin disease,it is due to weakness of spleen and kidney yang and cold transformation of Shaoyin;for Jueyin disease,it is because the spleen is weak and the liver is depressed,with the earth being invaded by wood.Regarding treatment principles and methods,ZHANG Zhongjing advocated supplementation as the main approach to warm and tonify the yang qi of the spleen and stomach;purgation as the secondary method to provide an outlet for pathogenic factors;emphasis on the combination of cold and heat treatment,and attention to the priorities of the root cause and symptoms.Additionally,his thought of“protecting the spleen and stomach”is manifested in aspects such as syndrome differentiation and treatment,prescription and medication,and“preventive treatment of diseases”.ZHANG Zhongjing's theory of the spleen and stomach has significant reference value for guiding the diagnosis and treatment of diseases and is worthy of reference and in-depth study by clinicians.

关 键 词：张仲景 脾胃学说 六经 顾护脾胃 

分 类 号：R256.3[医药卫生—中医内科学]