文章摘要
张译之,杨美霞,郑红斌.《黄帝内经》大肠病证阐要[J].浙江中医药大学学报,2023,47(6):596-601.
《黄帝内经》大肠病证阐要
Elaboration of Large Intestinal Diseases in The Yellow Emperor’s Inner Classic
DOI:10.16466/j.issn1005-5509.2023.06.003
中文关键词: 大肠病  大肠胀  大肠咳  大肠痹  肠痈  肠澼  黄帝内经  理论研究
英文关键词: large intestinal diseases  large intestinal distention  large intestine cough  large intestinal impediment  large intestinal welling abscess  large intestinal afflux  The Yellow Emperor’s Inner Classic  theoretical research
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)
作者单位
张译之 浙江中医药大学 杭州 310053 
杨美霞 浙江中医药大学 杭州 310053 
郑红斌 浙江中医药大学 杭州 310053 
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中文摘要:
      [目的] 对《黄帝内经》(以下简称《内经》)中五个大肠病证(大肠胀、大肠咳、大肠痹、肠痈、肠澼)进行理论挖掘和应用阐发。[方法] 学习《内经》相关条文,并结合历代医家的相关论述,从病因病机、临床表现、临证治疗三个方面对五者理论进行挖掘与阐发。[结果] 《内经》对五者的病因病机和临床表现均有较为详细与明确的论述。大肠胀的病因为厥气在下、寒气逆上,症见腹痛肠鸣等;大肠咳由肺咳日久传化所致,症见咳而遗矢;大肠痹则因饮食伤及肠胃在先、风寒湿三气错杂相合内传肠腑在后而病,症见多饮而小便不出等;肠痈由饮食情志、寒温不时所产生的病理产物之积聚所致,症见腹痛、痈上皮热等;肠澼为飧泄日久所致,症见飧泄、甚者便血。《内经》虽对五者的治疗疏于记载,却提出了相应的治法与治则,后世医家宗之并进行补充,逐渐形成了较为完善的治疗方案,主要分为针灸治疗与药物治疗两种治疗方法。[结论] 挖掘整理《内经》大肠病证理论,可为中医教学与临床诊治大肠疾病提供坚实的理论指导。对于《内经》中所述较少的治疗部分,后世医家基于《内经》理论与临床实践,对五者治法进行了发挥与补充,迄今为止于临床仍具重要的参考指导价值。
英文摘要:
      [Objective] To summarize and elucidate the theories and treatments of large intestinal diseases in The Yellow Emperor’s Inner Classic, including large intestinal distention, large intestine cough, large intestinal impediment, large intestinal swelling abscess, large intestinal afflux. [Methods] Studying The Yellow Emperor’s Inner Classic and physicians’ works about the five large intestinal diseases, it summarized and elucidated their etiologies and pathogenesis, clinical manifestations and treatment methods. [Results] The Yellow Emperor’s Inner Classic had detailed and clear expositions on the etiologies and pathogenesis and clinical manifestations of the five large intestinal diseases. Large intestinal distention was caused by that Wei Qi went below and cold Qi went upside, its symptoms included abdominal pain and bowel sounds, etc. Large intestine cough was caused by chronic pulmonary cough, its symptom was cough with fecal incontinence. Large intestinal impediment was caused by that diet hurted the intestines and stomach first, and the three Qi of wind, cold and dampness were mixed and transmitted internally to the large intestines later, its symptoms included polydipsia and urinary retention, etc. Large intestinal welling abscess were caused by the accumulation of pathological products produced by dietary, emotion and external evil, its symptoms included abdominal pain and skin fever. Large intestinal afflux was caused by chronic diarrhea, its symptoms included diarrhea and bloody stool. The Yellow Emperor’s Inner Classic neglected to record the treatment of these five diseases, but put forward their treatment principles. Later physicians complied with them and supplemented the treatment, which then gradually formed a more complete plan, including acupuncture and medical treatment. [Conclusion] Summarizing and elucidating the theories and treatments of large intestinal diseases in The Yellow Emperor’s Inner Classic provided a solid theoretical guidance for the teaching of traditional Chinese medicine and the clinical diagnosis and treatment of large intestinal diseases. As for treatment part which had a less discussion, based on the theories from The Yellow Emperor’s Inner Classic and clinical practices, later physicians had developed and supplemented their treatment methods, which still had important reference in clinic so far.
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