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伤寒论评话 第46章 厥阴吐利有寒热,病证属实非为虚——厥阴病吐利的辨证论治(三) 被引量:1

Discussion of Shanghan Lun : Chapter 46 Vomit and Diarrhea of Jueyin Inclids Cold and Hot, Which is Excess, not Deficiency-- Syndrome Differentiation and Treatment of Jueyin with Vomit and Diarrhea (3)
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摘要 1阳明病、少阴病和厥阴病呕吐症虽然均用吴茱萸汤,但其内涵不尽相同。阳明胃寒呕吐用吴茱萸汤是直指病灶,切中病机。而少阴病吐利、烦躁、厥逆以及厥阴病干呕、吐涎沫、头痛也使用吴茱萸汤,则是针对第二病机,是急则治其标的措施,其本在于少阴或者厥阴的寒盛,须在症状解除之际,从少阴心肾或者厥阴肝着手治疗,才能使疾病痊愈。2厥阴病寒热转化中从寒利转向热利过程中的脉数、口渴与单纯寒利的寒邪渐去、阳气恢复的微热、面赤不能等同视之,前者是由寒向热的转化,后者则是寒去阳复的佳兆;虽然都有自愈的可能,但前者若不自愈则会发展成为热利,甚或便下脓血,而后者的结果则是自愈。3"下利谵语者,有燥屎也,宜小承气汤。"燥屎内结是标,厥阴热盛是本,厥阴热极,耗灼津液,使燥实内结,不能因有燥屎,就认为病在阳明,更不能因使用小承气汤就将其归结为阳明病。大凡体内有热,不管是在何经何脏何腑,只要热盛伤津,导致燥屎内结,都会结滞在肠道,以承气汤治疗,既能够泻下燥屎以治标,更能够清热以治本。 ①Although Wuzhuyu Tang is used for vomit of Yangming, Shaoyin, Jueyin, they are not same. Vomit of Yangming caused by stomach cold,it's pointing the focus by fructus evodiae decoction. The fructus evodiae decoction used for vomit, diarrhea, irritable, cold limbs of Shaoyin and vomit,ptysis, headache of Jueni,which aimed the second pathogenesis. It is urgent is put to its external. The basis is excess cold of Shaoyin and Jueyin, which should be treated from heart an kidney or liver at the time of relieving the symptom,will be heated.②It is differente from rapid pulse, thirsty of the process of transforming the cold an hot in Jueyin and gradually remove cold, hot face, recovering yang of simple cold diarrhea. The former is frome cold to hot, the latter is the good news of removing clod and recovering yang. Alought they have self-healing ability, the former would be developed hot diarrhea, even purulent blood, the latter would be healed. ③Diarrhea and delirious speech,which indicated try feces, was given Xiao Chengqi Tang. The exterior is try feces. The basis isexcess hot,which caused by up to the hot of Jueyin, burned the body fluid; It is mistake that because of dry excrement, think the disease in the Yangming, more cannot be used for small gas bearing soup is summed up in Yangming disease. When the body is hot, where in any your inner parts, as long as the heat injuried fluid, causing dry excrement in the intestinal tract,whicn was given Chengqi Tang. It is both to remove dry feces and clear hot to curing under dry excrement to take temporary, more can clear heat to effect a permanent cure.
作者 梁华龙 LIANG Hualong( Henan University of Traditional Chinese Medicine, Zhengzhou Henan China 450046)
机构地区 河南中医学院
出处 《中医学报》 CAS 2015年第10期1420-1424,共5页 Journal of Henan University of Chinese Medicine
基金 国家中医药管理局专项课题(2009-0001) 河南省科技厅基金项目(496060303)
关键词 吴茱萸汤 厥阴病 呕吐 下利 承气汤 张仲景 伤寒论 wuzhuyu tang Jueyin disease vomit diarrhea chengqi tang Zhang Zhongjing Shanghanlun
作者简介 梁华龙(1958-),男,河南南阳人,医学硕士,教授,博士研究生导师,中华中医药学会仲景学说专业委员会副主任委员、河南省中医药学会仲景学说专业分会主任委员,主要从事中医,临床基础研究。
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