张仲景喘证病机传变及经方诊疗策略  

ZHANG Zhongjing’s perspective on the pathogenesis transmission and diagnosis and treatment strategies with classical prescriptions of dyspnea syndrome

作　　者：梁元钰 吕晓东[1] 庞立健[2] 臧凝子[2] 王天娇 刘勇明[1,2] 王靖宇 LIANG Yuanyu;LYU Xiaodong;PANG Lijian;ZANG Ningzi;WANG Tianjiao;LIU Yongming;WANG Jingyu(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

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

出　　处：《中华中医药杂志》2024年第12期6357-6361,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82274440,No.82004294,No.82204993,No.82204787);辽宁省名中医传承工作室建设项目(No.辽中医药函〔2021〕1号);辽宁省科技厅中央引导地方科技发展资金(No.2023JH6/100100025);国家中医药管理局项目(No.GZY-FJS-2023-020)。

摘　　要：文章以《伤寒杂病论》中与喘相关的条文为蓝本,总结了张仲景在喘证因机证治方面的学术经验,认为喘证总关乎肺,又不止于肺,从肺脏自病和他病及肺两方面论述喘证的发病机制。以六经辨证为纲,从三阳病、三阴病、合病角度揭示喘证的动态传变过程,提出正邪胜负关系是喘证传变和转归的关键。在方证相对思想的指导下,进一步说明喘证诊疗策略的核心在于抓住疾病的关键指征,见喘知病,辨证处方,随症加减,并梳理了《伤寒杂病论》中的部分治喘经方,为喘证的临床诊疗了提供理论支持和研究思路。Based on the original text related to dyspnea in the Treatise on Cold Pathogenic and Miscellaneous Diseases,this article summarized ZHANG Zhongjing’s academic experience in the pathogenesis,syndrome differentiation,and treatment of dyspnea syndrome.Dyspnea syndrome is always related to the lung,but not only to the lung.It discussed the pathogenesis of dyspnea syndrome from two perspectives:lung disease and other diseases that influenced the lung.Taking the six syndromes differentiation as the guideline,the dynamic transmission and transformation process of dyspnea syndrome was analyzed from the three yang diseases,three yin diseases,and combination diseases.The balance between pathogenic qi and healthy qi is the key to the transmission and transformation of dyspnea syndrome.Under the guidance of the view of correspondence of prescription and syndrome,this article further explained that the core of the diagnosis and treatment strategy for dyspnea syndrome is to grasp the key indications of the disease,differentiate symptoms and prescribe according to then,and modified decoction based on patients’syndrome.Part of the classical prescriptions in the Treatise on Cold Pathogenic and Miscellaneous Diseases for dyspnea syndrome was sorted out to provide theoretical support and research ideas for clinical diagnosis and treatment of dyspnea syndrome.

关 键 词：喘证 经方 《伤寒论》 《金匮要略》 六经传变 方证相对 诊疗 策略 张仲景 

分 类 号：R25[医药卫生—中医内科学]