摘要
张仲景的六经辨证、叶天士的卫气营血辨证、吴鞠通的三焦辨证均是外感病辨证施治的基础,虽其角度不同,但均揭示了外感病变化发展的规律,而在这三种辨证体系中,均贯穿着气血理论。《伤寒论》对痞证、结胸证、蓄血证的论述,体现了气血理论在外感病发展过程中的演变规律。从痞证到结胸证再到蓄血证,是由病在气到病在气或血,再到病在血的过程。治疗上以调气为先,再气血同治,而调气之法有散邪热、扶正气的作用。病在气当治气,病在血却不可一味治血,必气血同治。临床辨证要将气血与寒热、表里、虚实的辨证结合在一起,辨气血之病位、病性,病理产物以及相互影响关系,辨证精准,用药才可精当。
Qi-blood theory is an important part of the basic theory of TCM with its own characteristics.In Treatise on Cold Damage Diseases,a large number of diseases and syndromes are described.From the symptoms and medication,the law of disease and syndromes can be observed.Especially,the discussion on abdominal mass syndrome,syndrome of accumulation of pathogenic factor in chest,and blood-retention syndrome can reflect the evolution law of qi-blood theory in the development of exogenous diseases.From abdominal mass syndrome,syndrome of accumulation of pathogenic factor in chest,and blood-retention syndrome,it is a process from disease in qi or blood,and then to disease in blood.The treatment based on qi-blood theory runs through exogenous and internal injuries,which is the core principle.In Treatise on Cold Damage Diseases,it is emphasized that "all diseases arise from qi disorder".In the treatment,regulating qi is the first step,then treating qi and blood together follow.The method of regulating qi has the function of dispelling pathogenic heat and strengthening qi,which should be paid attention to clinically.If disease exists in qi,regulating qi should be used.However,if disease exists in blood,qi and blood must be treated together rather than treating blood singly.Clinical syndrome differentiation can not only stay in yin and yang,but also should combine qi and blood with cold and heat,exterior and interior,deficiency and excess syndrome differentiation.The differentiation of syndrome differentiation is more detailed and hierarchical.The location,disease nature,pathological products of qi and blood and their mutual influence can be distinguished accurately.Only when the differentiation of syndrome is accurate,can the medication be used properly and flexibly,and the clinical effect can be remarkable.
作者
陈晓晖
CHEN Xiao-hui(Wusong Street Community Health Service Center of Baoshan District of Shanghai,Shanghai,China,201900)
出处
《河南中医》
2019年第12期1802-1804,共3页
Henan Traditional Chinese Medicine
基金
上海市宝山区科学技术委员会科技创新项目(17-E-47)
关键词
气血理论
痞证
结胸证
蓄血证
治气
活血
气血同治
qi-blood theory
abdominal mass syndrome
syndrome of accumulation of pathogenic factor in chest
blood-retention syndrome
treating qi
treating blood
treating both qi and blood
