《伤寒论》表证分经论治初探

The Probe into Therapy with Forked Meridian Differentiation of Exo-Syndrome in Treatise on Cold-Damaged Diseases

《伤寒论》论治表证,除兼变证及合病三阴外,纯以表证论者,主要有麻黄汤证、桂枝汤证、桂枝麻黄各半汤证、桂枝二麻黄一汤证、葛根汤证、大青龙汤证、小柴胡汤证、柴胡桂枝汤证等,虽统称治表,但具体病位、证治机理、证候表现均有不同,仲景随证选用不同汤方充分体现了分经论治的精神。《伤寒论》认为三阳病皆有表证,非太阳专属,故从太阳、阳明、少阳分经论治表证。太阳表证在皮毛,主方麻黄汤,主药麻黄;阳明表证在肌肉,主方葛根汤,主药葛根;少阳表证在腠理,主方是小柴胡汤,主药是柴胡。

In terms of exo-syndrome,except complicated syndrome and disease involving three yin meridian,in Treatise on ColdDamaged Diseases,there are some therapies mainly dealing with pure exo-syndromes,including syndrome of Ephedrae Decoction,syndrome of Ramulus Cinnamomi Decoction,syndrome of half Ramulus Cinnamomi and half Ephedrae Decoction,syndrome of two Ramulus Cinnamomi and one Ephedrae Decoction,syndrome of Puerariae Decoction,syndrome of Large Qinglong Decoction,syndrome of Small Bupleuri Decoction,syndrome of Bupleuri and Ramulus Cinnamomi Decoction,etc. Though all these are for treating exo-syndromes,disease site,pathogenesis and symptoms are different from each other. Zhang Zhong-jing＇s choice of decoction prescription with syndrome differentiation fully embodies the spirit of therapy with forked meridian differentiation. Diseases involving three yang meridians all have exo-syndromes which do not simply belong to taiyang diseases. Therefore,taiyang meridian diseases,yangming meridian diseases and shaoyang meridian diseases should be treated with therapy with forked meridian differentiation. The exo-syndromes of taiyang meridian diseases lie in skin and hair; The main prescription is Ephedrae Decoction; The main herb is Ephedrae. The exo-syndromes of yangming meridian diseases lie in muscles; The main prescription is Puerariae Decoction;The main herb is Puerariae. The exo-syndromes of shaoyang meridian diseases lie in connecting tissues; The main prescription is Small Bupleuri Decoction; The main herb is Bupleuri.