太阳病蓄血证的证型初探

Primary Discussion on Differentiation of the Syndrome of Blood Stasis and Heat Stagnated in the Bladder

对照审视《伤寒论》原文 10 6条和 12 4条 ,分析“热结膀胱”与“太阳随经”、“热在下焦”及“太阳病不解”与“太阳病六七日”的不同内涵 ,对太阳病蓄血证进行辨析 ,认为太阳蓄血证有两个证型 ,其一是热结膀胱型 ,其二是热瘀肠府型。“热结膀胱”为邪热随经入府 ,病变部位就在膀胱 ;“热在下焦”是一动态概念 ,意指太阳之邪随手太阳小肠经内传小肠 ,邪热移入大肠而与瘀血互结的病变过程 ,其病变部位终至大肠。两者无论在邪气化热入里的途径、病变部位、证候表现方面 ,还是病势转归、治则及治法方面均有所不同 ,两者不可不辨。

According to the analysis on the syndromes of 'heat stagnated in the bladder','heat transmiting from the small intestine to the large intestine along the meridian','heat stagnated in the lower Jiao','unhealed Taiyang syndrome'and 'the sixth to seventh day of Taiyang syndrome',based on the description of item 106 and item 124 in the book of Treatise on Febrile Diseases Caused by Cold ,the syndrome of blood stasis and heat stagnated in the bladder includes two types:heat stagnated in the bladder and heat and blood stagnated in the bladder.The difference on the pathways of the evil transmitting into heat and going deeper,pathogenic positions,manifestations,pathogenic transmission,treatment principles and methods between above two types should be differentiated clearly.