摘要
《伤寒论》第252条、第253条、第254条所论病证被称为阳明急下三证,三证病因均为阳明热实,但相同的病因所致症状及转归不同,与患者体质密切相关。原文第252条突出了“目中不了了,睛不和”症状,为患者平素肝肾阴虚,是阴虚体质,热病后津液更伤,损及肝阴,全身筋脉失养,易导致痉病,治疗可在大承气汤基础上加栝楼桂枝汤。原文第253条主要突出了汗多之症,为患者平素易自汗,是气虚体质,热病后气津两伤,虚热内生,中气不足,易转归为劳复病,治疗应先下后清补,清补用竹叶石膏汤。原文第254条主要突出了腹满痛症状,为患者平素气机不畅,是气郁体质,热病后邪热进一步阻滞气机,加重气滞程度,易转变为热厥,可用大柴胡汤下之。
The diseases discussed in Article 252,253,and 254 of Treatise on Cold Damage Disease are collectively known as three urgent syndromes of yang brightness.The three syndromes all have the same cause of yang brightness excessive heat,but their symptoms and outcomes are different,which is closely related to the patient's physical constitution.The Article 252 highlights the symptoms of "blurred vision and glazed with unmoving eyes,staring blankly," which indicates that the patient has liver-kidney yin deficiency and is an inherent yin deficiency constitution.After heat disease,the patient's body fluids are further damaged,and the liver yin is injured.The tendons and blood vessels throughout the body are not nourished,which can easily lead to convulsions.Trichosanthes and Cinnamon Twig Decoction can be used on the basis of Major Purgative Decoction.The original text of Article 253 mainly highlights the syndrome of excessive sweating.The patient is prone to spontaneous sweating and has a qi deficiency constitution.After heat disease,both qi and fluid are injured,and the deficiency heat is endogenous with insufficient middle qi,which can easily lead to relapse of disease due to overstrain.Treatment should start with purging followed by clearing and tonifying,Lophatherum and Gypsum Decoction should be used for clearing and tonifying.The original text of Article 254 mainly highlights the symptom of abdominal fullness and pain,which is usually due to the patient's poor qi circulation and a qi stagnation constitution.After heat disease,pathogenic heat further blocks the qi circulation,exacerbates the degree of qi stagnation,and easily transforms into heat syncope.It can be treated with Major Purgative Decoction.
作者
张琳琳
仲乃堂
杜威
王献
谢毅强
李凯
ZHANG Linlin;ZHONG Naitang;DU Wei;WANG Xian;XIE Yiqiang;LI Kai(Hainan Medical University,Haikou,Hainan,China,571199)
出处
《河南中医》
2024年第7期978-982,共5页
Henan Traditional Chinese Medicine
基金
海南省高等学校教育教学改革研究项目重点项目(Hnjg2023ZD-32)
海南省“南海新星”教育平台项目(JYNHXX2023-16G)
海南医学院教学成果奖培育项目(HYjcpx202210)
海南医学院教育科研课题项目(HYYB202203)。
关键词
阳明急下三证
痉病
劳复病
厥逆证
大承气汤
《伤寒论》
张仲景
three urgent syndromes of yang brightness
convulsions
relapse of disease due to overstrain
syncope
Major Purgative Decoction
Treatise on Cold Damage Disease
Zhang Zhongjing
