摘要
目的:探讨《伤寒论》所记载蓄水证的成因与治疗方法。方法:对《伤寒论》第67条、第69条、第71条、第72条、第73条、第74条进行分析。结果:①五苓散证和茯苓甘草汤正同为蓄水,但前者的蓄水量大且处于发展状态,已经影响到津液的化生,所以口渴和小便不利同时存在,且表有留邪而脉浮发热;而后者蓄水量小且形成后不再发展,尚未波及津液的化生,所以仅有小便不利而无口渴,且表邪已尽仅为蓄水。故其治疗时以茯苓利水,生姜散水,桂枝化水,甘草制水(通过益脾而制约水湿的继续产生),通利已蓄积而不再继续增多的蓄水。②水逆和火逆两病是在古代简陋的医疗条件下,采用"水法""火法"治疗伤寒等热性病,经常发生的医疗事故所造成的两种后果。水逆,其表现多为"喘""烦""意欲饮水,反不渴""渴欲饮水,水入则吐""肉上粟起"等。火逆的表现尤为复杂,以神、色异常表现为主,比如发黄、烦躁、惊狂、谵语等,且极易波及血分。③无论从生理或者是病理上来看,"心开窍于耳"都有其合理性,五行中心属火,火性炎上,耳在上,易与心气相通,心之清阳濡养耳窍;而肾属水,水性趋下,二阴在下,易与肾气相通,浊阴出于下窍。若说肾开窍于耳,既与其肾脏属水下行的特性不符,而且距离较远,不符合"上竞上,下竞下""清阳出上窍,浊阴出下窍"原则。结论:探讨蓄水证的成因与治疗方法对现代临床应用具有指导意义。
Objective ：To investigate the causes and treatment of stagnated fluid syndrome recorded in Treatise on Febrile Disease. Meth- ods ： Article 67, article 69, article 67, article 72, article 73, article 74 of Treatise on Febrile Disease were analyzed. Results ： @Wuling San syndrome and Fuling Gancao Soup syndrome are both the same for water storage, but the former with big amount of stagnated fluid and is in a state of development,which already affects the production of body fluid,so symptoms of thirst and dysuria exist at the same time, and lingering evils hampering the exterior result in floating pulse and fever;The latter with small amount of stagnated fluid and is no longer de,~e^opme^t after the formation of stasnated fluid,which has not ~et spread the generation of body fluid,so only dysuria with- out thirst, and exterior evil has been eliminated and only stagnated fluid remained. So its treatment is promoting the stagnated fluid which has already been accumulated but no longer continuous addition. @Water inverse and fire inverse are two consequences caused by frequently-occurring medical accidents resulting from using ＂water method＂ and ＂fire method＂ treatment of heat disease, such as ty- phoid fever in the ancient rudimentary medical conditions. The Performance of water inverse is ＂out of breathe＂ ＂thirst for water, then spit into the water＂ and ＂ skin getting goose flesh＂ , etc. , and the performance of fire inverse is especially complex, and mainly with dysphoria, surprised, delirious speech, etc. ,which can easily spread to Xuefen. （~）＂ Heart opening at ear＂ has its rationality Either from the perspective of physiological or pathological. The five elememts center belongs to fire, fire flaming upwards nature, and ear in top lo- cation, it can connect with heart qi easily. Qing yang of heart can moisten the ears. And kidney belongs to water, water tending to de- scend, and two lower orifices in down location, they can connect with kidney qi easily, and turbid yin out of fro
出处
《中医学报》
CAS
2013年第6期812-815,共4页
Acta Chinese Medicine
基金
国家中医药管理局专项课题(编号:2009-0001)
河南省科技厅基金项目(编号:496060303)
关键词
伤寒论
张仲景
蓄水证
火逆
水逆
Treatise on Febrile Disease
Zhang Zhongjing
stagnated fluid syndrome
fire inverse
water inverse
