《伤寒论》中“胃气”思想在病脉辨证中的运用

The Application of the Idea of Stomach Qi of Treatise on Cold-Induced Disease in the Differentiation of Disease and Pulse

[目的]探析《伤寒论》中"胃气"思想在病脉辨证中的运用。[方法]逐条摘录《伤寒论》中与胃气相关的服药、饮食、大便、脉象等条文,归纳其胃气思想在疾病诊断、治疗、预后等方面的运用。[结果]《伤寒论》主张试验性地投用水谷和药物以测胃气之盛衰。药食后发热则胃气受损、疾病难愈,不发热则胃气尚存、疾病易愈;腹中转矢气则胃气实、可攻下,无矢气则胃气虚、不可攻下。能食代表中焦实热、胃气来复或中焦虚极;不能食者根据伴随症状又有寒、热、虚、实之分。通过观察大便的数量、颜色、形状、次数、气味,可推断疾病的寒、热、虚、实、瘀血。脉证相符提示胃气尚存、病重能愈;脉证不符提示胃气衰败、病轻难愈;趺阳脉(冲阳脉)浮、太溪脉小于趺阳脉均是有胃气的表现。[结论]《伤寒论》常通过试药食、问饮食、审大便、切脉博来判断胃气的盛衰和戾、推断疾病的性质和轻重。

[Objective] To analyze the application of the idea of Stomach Qi of Treatise on Cold-Induced Disease in the differentiation of disease and pulse. [Method] To choose and analyze the articles, line by line, related to stomach Qi, including trying to treat, diet, stool and pulse, and to conclude the application of stomach Qi thought in disease diagnosis, cure and predicting the condition of disease.[Kesult] Treatise on Cold-Induced Disease advocating trying drug and food, if there was fever after drug and food, it meant stomach Qi was impaired, and it was hard to cure the diseases. On the contrary, there was stomach Qi, it was easy to cure the diseases. By using Xiao Chengqi Tang to try, if there was flatus to turn, it meant that stomach Qi was strong, and Catharis could be used. On the contrary, catharis could not be used. Being able to eat meaned that there was sthenic fever in middle energizer,or stomach Qi was recovering, or middle energizer was very deficient. Being not able to eat meaned the different condition of stomach Qi, according to the accompaning symptoms. Though observing the amount, shapes, colours,smefl and frequency of feces, the conditions of heat and cold, deficiency and excess of a disease could be concluded. If syndrome and pulse were consistent, it meant that Stomach Qi still existed, and a serious illness could be cured. conversely stomach Qi was extremely deficient, and it was hard to cure a mild illness. Floating FuYang pulse and too creek pulse being smaller than ChongYang pulse all meaned stomach Qi existing.[Result] Treatise on Cold-Induced Disease often judged the ups and downs of stomach Qi according to the differentiation of disease and pulse ,to predict the condition of disease.