从《临证指南医案》肺痹与肠痹证治探讨“肺与大肠相表里”

Theory of lung and large intestine being interior-exteriorly related,and lung impediment and intestine impediment in Linzheng Zhinan Yi'an

"肺与大肠相表里"的脏腑相关理论是中医的特色理论之一,在历代医家的众多医籍中均有所论述。通过研习《临证指南医案》中所载的肺痹和肠痹医案,从症状表现、病因病机以及治法方药等方面,分析叶天士临证时对"肺与大肠相表里"理论的认识和应用。研究发现,"肺与大肠相表里"所论之肺与大肠之间的关系是相互的,不仅存在肠病可及肺、肺病可治肠,反之亦存在,且并不存在情况的多寡问题,只是肺与大肠所主不同,在不同疾病不同证型中,会有所侧重而已。肺病与肠病之间互相影响的情况是存在一定发生条件的,而且肺病治肠、肠病治肺亦非在所有肺病和肠病中都适用,不可以偏概全。

The theory of zang-fu organs being related including lung and large intestine being interiorexteriorly related is one of characteristic theories of Chinese medicine and is recorded in a lot of medical books in all ages. Through studying the medical records of lung impediment and intestine impediment in Yi＇an, the authors analyzed YE Tian-shi＇s cognition and application of the theory of lung and large intestine being interior-exteriorly related from the aspects of symptoms, causes, pathogenesis, therapies, formulas and medications. They found that lung and large intestine have a mutual relationship, so the diseases of large intestine will involve lung and lung diseases can be treated from large intestine, and vice versa. Because lung and large intestine have different governing, the manifestations will be different in different diseases and syndrome types. The interaction between lung and large intestine exists under certain conditions, and lung diseases treated from large intestine or intestinal diseases treated from lung are not suitable for all diseases of lung or large intestine.