| 郝亚非,徐光星.基于六经气化学说的张志聪三阳阳明病浅析[J].浙江中医药大学学报,2023,47(5):479-482, 489. |
| 基于六经气化学说的张志聪三阳阳明病浅析 |
| Analysis of ZHANG Zhicong‘s Three-Yang Yangming Disease Based on the Theory of Six-meridian Qi-transformation |
| DOI：10.16466/j.issn1005-5509.2023.05.004 |
| 中文关键词: 三阳阳明病 伤寒论 阳明病 六经气化 张志聪 伤寒论集注 黄帝内经 五运六气 |
| 英文关键词: three-Yang Yangming disease Treatise on Exogenous Febrile Disease Yangming disease six-meridian Qi-transformation ZHANG Zhicong Collected Commentaries on Treatise on Exogenous Febrile Disease Huangdi Neijing five movements and six Qi |
| 基金项目:浙江省中医药科技计划中医药现代化专项项目(2020ZX002) |
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| 中文摘要: |
| [目的] 浅析张志聪基于六经气化学说的《伤寒论》三阳阳明病相关论述，为更好地理解及临证运用伤寒阳明病相关理论提供参考。[方法] 通过研读张志聪《伤寒论集注》《伤寒论宗印》《黄帝内经素问集注》等著作，旁参其他医家关于《伤寒论》及六经气化学说的相关研究文献，简要解析张志聪六经气化学说，并从症候表现、病机本质、方药选用等方面阐释其对三阳阳明病的分析论述。 [结果] 六经气化学说为张志聪依照运气学知识，将六气气化和伤寒三阴三阳病脉证并治体系具体结合的学说思想。三阳阳明病症候表现，在不更衣、内实、大便难等“胃家实”症状的基础上各有不同侧重，太阳阳明病兼有小便数，正阳阳明病强调腑实，少阳阳明病兼有心烦。太阳阳明病病机为太阳阳热之气入于太阴脾土，脾阴受损不能为胃行其津液；正阳阳明病病机为阳明燥金之气及悍热之气侵袭阳明本腑经所致液少津亏；少阳阳明病病机为三焦受邪，少阳枢转不利，误治失津而阳明液损。太阳阳明病方选助脾输津、通腑行便的麻子仁丸；正阳阳明病方选推陈置新、荡涤攻邪的大承气汤，少阳阳明病方选承热畅中的调胃承气汤或疏导气机、交通阴阳的小柴胡汤。 [结论] 基于六经气化学说对三阳阳明病机的分析探究，揭示了人体无形之气与有形之质的紧密联系，二者共同决定了脏腑经络的生理机制及病理反应。 |
| 英文摘要: |
| [Objective] To analyze ZHANG Zhicong‘s three-Yang Yangming disease of Treatise on Exogenous Febrile Disease based on the theory of Six-meridian Qi-transformation and to provide reference for better understanding and clinical application of the theory of Yangming diseases. [Methods] Through studying ZHANG Zhicong‘s Collected Commentaries on Treatise on Exogenous Febrile Disease， Confirmed Explanation on Treatise on Exogenous Febrile Disease， Collected Commentaries on Huangdi Neijing Suwen and other works， and referring to the relevant research literature of other doctors on Treatise on Exogenous Febrile Disease and the theory of Six-meridian Qi-transformation， this paper briefly analyzed ZHANG Zhicong‘s theory of Six-meridian Qi-transformation， and explained the analysis and discussion on three-Yang Yangming disease from symptom expressions， pathogenesis essence and prescription selection. [Results] Six-meridian Qi-transformation theory is a specific combination of doctrines which was proposed by ZHANG Zhicong in accordance with the knowledge of Yun-Qi theory， the Qi-transformation and three Yin and three Yang diseases， pulse， syndrome and treatment system of Treatise on Exogenous Febrile Disease. There are different emphasis based on defecation difficulty about three-Yang Yangming disease‘s symptoms. Taiyang Yangming includes frequent urination， Zhengyang Yangming disease emphasizes sthenia syndrome of stomach and intestine， Shaoyang Yangming includes dysphoria. The pathogenesis of Taiyang Yangming disease is that Taiyang heat Qi enters the Taiyin earth， and the spleen Yin is damaged and cannot transfer its body fluid for the stomach. The pathogenesis of Zhengyang Yangming disease is deficiency of fluid and body fluid of Yangming internal organs caused by the invasion of Yangming dry and hot Qi. The pathogenesis of Shaoyang Yangming disease is that tri-Jiao is suffered from evil， and fluid loss of stomach and intestine is caused by mistaken cure. The Maziren pill is selected to help the spleen to transport the body fluid and dredge the bowels on Taiyang Yangming disease. Dachengqi decoction is selected to attack evil and subside fever on Zhengyang Yangming disease. On Shaoyang Yangming disease， Tiaowei Chengqi decoction is selected to help removing heat to loosen bowels and Xiaochaihu decoction is selected to dredge Qi flow and transport Yin and Yang. [Conclusion] Based on the theory of Six-meridian Qi-transformation， the analysis of three-Yang Yangming diseases reveals the close relationship between the intangible Qi and the tangible quality of human body， which together determine the physiological mechanism and pathological reaction of Zang-Fu organs and meridians. |
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