期刊文献+

《黄帝内经》“五实”“五虚”新解

A new interpretation on five-excess and five-deficiency in Huangdi Neijing
收藏 分享 导出
摘要 《黄帝内经》之《素问·玉机真脏论篇》中提出了'五实''五虚'的说法,五实包含'脉盛,皮热,腹胀,前后不通,闷瞀'5个症状,五虚包含'脉细,皮寒,气少,泄利前后,饮食不入'5个症状。王冰、张景岳、张志聪等古代注家均从五脏虚实来解读,可能有失经旨。本文提出了新见解,认为五实是气机壅实之证,即今之所谓闭证;五虚是元气虚衰之证,即今之所谓脱证。在原文中,闭证是通过发汗、通下以拨转气机来治疗,脱证是通过补养胃气、滋生化源来治疗,这或是后世开窍启闭、益气固脱等治疗思想的源头。'五实''五虚'之'五'是一种计数,强调5个症状都具备是做出可靠诊断的必要条件,这种表述方法有利于临床经验的传承和诊断特异性的提高。从闭、脱解读五实五虚在逻辑上合理,在临床上合实,此段经文可能是中医对闭脱二证最早的论述。 The statements of five-excess and five-deficiency were put forward in Yuji Zhenzang Lun(Discussion on Genuine-zang Pulses)in Huangdi Neijing:Suwen(Yellow Emperor’s Internal Classic:Plain Conversation).The five-excess contains five symptoms including vibrant pulse,skin fever,abdominal distension,obstruction of urine and stool and delirium,and five-deficiency contains five symptoms including fine pulse,cold skin,less qi,incontinence of urine and stool,and incompatibility of diet.Ancient annotators such as Wang Bing,Zhang Jingyue and Zhang Zhicong all interpreted the statements from the excess and deficiency of five zang-organs,which may lose the original meaning.The paper puts forward a new view that the five-excess is qi movement congesting,i.e.so-called block pattern today,and five-deficiency is pattern of deficient original qi,i.e.so-called collapse pattern today.In the original text,the block pattern is treated with regulating qi movement through perspiration and defecation,and the collapse pattern is treated with therapies of nourishing stomach qi and nourishing the sources of qi.These may be the source of the therapeutic ideas such as opening orifices and block,and replenishing qi and relieving collapse.The'five'in five-excess and five-deficiency means count and emphasizes that all five symptoms are necessary conditions to make a reliable diagnosis.This expression method is conducive to the inheritance of clinical experiences and improvement of diagnostic specificity.The interpretation of five-excess and five-deficiency from block pattern and collapse pattern is logically reasonable and clinically realistic.This classic text may be the earliest record about block pattern and collapse pattern in Chinese medicine.
作者 张天星 Zhang Tianxing(School of Basic Medical Science,Zhejiang Chinese Medicine University,Zhejiang 310053,China)
出处 《北京中医药大学学报》 CAS CSCD 北大核心 2019年第8期625-628,共4页 Journal of Beijing University of Traditional Chinese Medicine
基金 浙江中医药大学校级科研基金资助项目(No.2018SR03).
关键词 五实 五虚 闭证 脱证 黄帝内经 five-excess five-deficiency block pattern collapse pattern Huangdi Neijing(Yellow Emperor’s Internal Classic)
作者简介 通讯作者:张天星,男,博士,讲师,E-mail:ztxl@163.com
  • 相关文献
投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈