从《伤寒杂病论》“表里体系”看黄疸病的“证与方”及其临床指归  

Discussion on“Syndrome and Prescription”of Jaundice and Its Clinical Implications from“Exterior and Interior System”of Treatise on Typhoid Miscellaneous Diseases

作　　者：李飞燕 毛德文[1] 蒋海南 王明刚[2] LI Feiyan;MAO Dewen;JIANG Hainan;WANG Minggang(Graduate School of Guangxi University of Chinese Medicine,Nanning 530200,Guangxi,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,Guangxi,China)

机构地区：[1]广西中医药大学研究生院,广西南宁530200 [2]广西中医药大学第一附属医院,广西南宁530023

出　　处：《辽宁中医杂志》2024年第5期64-66,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81960841);广西自然科学基金创新团队项目(2018GXNSFGA281002);广西中医药大学博士启动基金项目(2020BS026);广西中医药大学一流学科建设开放课题项目(2019XK003);广西中医药大学硕士研究生科研创新项目(YCSY2022024);广西研究生教育创新计划项目(YCSW2023378,YCBZ2023157,YCSW2023384)

摘　　要：《伤寒杂病论》中关于黄疸病的认识独到且深入,根据外感伤寒、瘀热在里及寒湿在里不化的病机机理,提出“湿邪伤人,法当汗出而解或利其小便”的基本治疗原则。笔者以表里辨证思想为基准,分析仲景《伤寒杂病论》中黄疸病的不同病位进而分别采取的治疗方药和思路,具体体现在3个不同的维度:在表者—麻黄连翘赤小豆汤;在里者—茵陈蒿汤;在半表半里者—大柴胡汤。表里辨证法为临床黄疸病的治疗提供了新思路。Treatise on Typhoid Miscellaneous Diseases has a unique and in-depth understanding of jaundice,and based on the pathogenesis of external cold,heat stagnation in the interior and cold-dampness in the interior without resolving,the basic therapeutic principle that“when dampness injures a person,the method should be to sweat out and resolve it or to facilitate its urination”is proposed.Based on the idea of the syndrome differentiation of the exterior and the interior,the author analyzed the different pathological positions of jaundice in Zhongjing's Treatise on Typhoid Miscellaneous Diseases and then adopted the respective therapeutic prescriptions and ideas,which were reflected in three different dimensions:for those with exterior syndrome—Mahuang Lianqiao Chixiaodou Decoction(麻黄连翘赤小豆汤);for those with interior syndrome—Yinchenhao Decoction(茵陈蒿汤);for those with half-exterior half-interior syndrome—Dachaihu Decoction(大柴胡汤).The syndrome differentiation of the exterior and the interior provides new ideas for the treatment of clinical jaundice.

关 键 词：黄疸病 表里辨证 《伤寒杂病论》 麻黄连翘赤小豆汤 茵陈蒿汤 大柴胡汤 

分 类 号：R254.1[医药卫生—中医内科学]