《金匮要略·水气病脉证并治》病证概念疏证  

Conceptual clarification of the disease and syndrome concept in the Chapter of Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease of Synopsis of Golden Chamber

作　　者：贾春华 赖敏 李湛 JIA Chunhua;LAI Min;LI Zhan(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《北京中医药大学学报》2025年第2期149-153,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.82074582)。

摘　　要：《水气病脉证并治》是《金匮要略》的难解篇章,该篇虽名“水气病”之论治,而实论治水气病、黄汗病、气分病等多种疾病,以致后人多将诸病皆视为水气病,难以正确理解本篇的诊疗思想。本文在甄别水气为致病因素、水气病为病名,并分析二者间关系的基础上,提出水气之认知原型为自然界水循环异常所致的液态水与气态水的蓄积,论证张仲景从气态水的生成、聚集和消散认识水气病的主证、病机和治疗原则。继而,从版本文献和因机证治出发,例证水气病、黄汗病、气分病是三种独立的疾病;从命名、病机、病证澄清气分病、血分病、水分病之关系,指出张仲景在《水气病脉证并治》的论述乃围绕三者“病水”展开的病证鉴别。厘清《水气病脉证并治》各病证概念及其关系,有助于系统、深入地阐发张仲景辨治水气病的原则与思想。The Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease chapter of Synopsis of Golden Chamber is regarded as one of its most challenging sections.Although nominally focused on water qi disease,this chapter also discusses yellowish sweating disease,qifen disease,and other diseases.This multiplicity of topics led to the misconception that all these diseases are water qi diseases,complicating the diagnosis and treatment strategies.By distinguishing water qi as both a pathogenic factor and a disease entity,this paper redefines the concept,linking it to the abnormal accumulation of liquid and gaseous water in the body,akin to the disrupted water cycle of the nature.It demonstrates that ZHANG Zhongjing recognizes the primary syndrome,pathogenesis,and therapeutic principles of water qi disease from the generation,aggregation,and dissipation of vaporous water.The study further differentiates water qi disease,yellowish sweating disease,and qifen disease as distinct entities.An analysis of their etiology,pathogenesis,syndromes,and treatment approaches establishes their independence while exploring their interrelations.Moreover,the relationships among the qifen,xuefen,and water phase diseases are clarified.ZHANG Zhongjing′s discussion in the Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease identifies the three diseases around the three "disease of water phase." The clarification of the concepts and relationships of the diseases in the Simultaneous Treatment of Pulse and Syndrome of Water Qi Disease will help to systematically and thoroughly elucidate ZHANG Zhongjing′s principles and thoughts on identifying and treating water qi disease.

关 键 词：金匮要略 水气病 黄汗病 气分病 

分 类 号：R222.3[医药卫生—中医基础理论]