孙思邈“伤任脉下血”思想对“奇经理论”的传承与发展  

Inheritance and development of SUN Simiao's thought of ‘injury under the Renmai' to the ‘Qi Jing theory'

作　　者：蒋啸 李鑫辉 李彩云 夏旭婷 王慧 刘贵淳 JIANG Xiao;LI Xinhui;LI Caiyun;XIA Xuting;WANG Hui;LIU Guichun(School of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208

出　　处：《中华中医药杂志》2025年第1期44-48,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.82074392);湖南省中医药管理局重点课题(No.A2023013);湖南省自然科学基金区域联合项目(No.2023JJ50036);湖南省教育厅重点项目(No.23A0283);湖南省研究生科研创新项目(No.CX20240746);南中医药大学研究生创新项目(No.2024CX149);湖南中医药大学校级预研项目(No.2024XJYY01)。

摘　　要：“伤任脉下血”是孙思邈总结隋唐以前崩漏病因时提出的重要认识,该认识将“奇经理论”引入妇科辨证,并在此基础上创制以小牛角?散为代表的方剂,弥补了隋唐以前论多治少的缺憾。在研究“奇经理论”的过程中发现:学界虽对此理论推崇备至,但因《千金方》文辞古奥、略而不悉,造成目前对该理论的研究缺乏系统性的溯源与对比,认知深度尚待深入。基于上述问题,文章以孙思邈提出“伤任脉下血”时间点为矩,采用原旨分析、理论溯源、对比研究等方法认为:隋唐以前,“奇经理论”仅作为理论认知散落于《黄帝内经》《难经》个别篇目中,未完成体系性建构;“奇经理论”的临证实践肇始于隋唐,由孙思邈以“伤任脉下血”作为病因提出,纳入崩漏辨证。在“奇经理论”的发展过程中,孙思邈起到学思践悟、以知促行的重要作用。后世滑寿、李时珍、叶天士三家纵论充实了“奇经理论”,不仅再次丰富妇科辨证思路,还将该理论推广至临床各科,用于指导复杂性、难治性疾病的论治。‘Injury under the Renmai' is an important understanding proposed by SUN Simiao when summarizing the causes of the metrorrhagia and metrostaxis in gynecology before the Sui and Tang Dynasties,and it pushes the ‘Qijing theory' to the clinical syndrome differentiation of gynecology.From this theory,SUN Simiao created formulas represented by Xiaoniujiaosai Powder,which made up for the deficiency of more discussion and less treatment before the Sui and Tang dynasties.However,in the process of studying ‘Qijing theory',it is found that although the academic community highly praised it,due to the ancient and abstruse words of Qianjin Fang,there is still a lack of systematic traceability and comparison of the current research on this theory,and the depth of cognition needs to be deepened.Based on the above problems,the paper takes the time node when SUN Simiao proposed ‘injury under the Renmai' as the moment,and adopts the methods of original intention analysis,origin tracing and comparative research,and finds that before the Sui and Tang dynasties,the ‘Qijing theory' was only scattered in individual chapters of Huangdi Neijing and Nanjing as theoretical cognition,and the systematic construction was not completed;the clinical practice of the ‘Qijing theory' began in the Sui and Tang dynasties,when SUN Simiao proposed ‘injury under the Renmai' as the cause of the disease and included it in the syndrome differentiation of metrorrhagia and metrostaxis.In the development process of ‘Qijing theory',SUN Simiao played an important role in learning,thinking and practicing enlightenment and promoting practice with knowledge.Later generations of longevity,HUA Shou,LI Shizhen and YE Tianshi enriched the ‘strange classics theory',which not only enriched the syndrome differentiation thinking of gynecology,but also extended the ‘Qijing theory' to complex and refractory diseases in all clinical departments.

关 键 词：孙思邈 伤任脉下血 奇经理论 学术源流 理论探讨 叶天士 

分 类 号：R249[医药卫生—中医临床基础]