由《伤寒论》《金匮要略》中心下痞与恶寒的联系引发的思考

Reflection on the relationship between epigastric fullness and aversion to cold in treatise on febrile diseases and synopsis of golden chamber

心下痞与恶寒的病机分别为脾胃气机升降失常与肌表卫气出入不利。本文从分析《伤寒论》《金匮要略》中二者共见的条文着手,结合仲景对此所施方药及《黄帝内经》中卫气理论与升降出入理论,得出表证与脾胃症状密切相关,多存在"必有表,复有里"的现象。且由于升降与出入相因,调营卫出入以利脾胃升降不失为临床上遇到棘手案例时的一种尝试方法。

The pathogenesis of epigastric fullness is ascending and descending disorder of splenogastric Qi, and that of aversion to cold is exiting and entering disorder of defense Qi. Based on the a- nalysis of the ＂treatise on febrile diseases＂ and ＂golden chamber＂ in the two common original texts, combine with the prescription of Zhang Zhong-jing and the theory of defense Qi and the theory of ascending, descending, exiting, entering in Huangdi Neifing, this paper concluded that splenogastric syndrome is closely related to exosyndrome. Because of the relationship of ascending, descending and exiting, entering, it is a good try to regulate exiting and entering of yingqi and weiqi for the sake of ascending and descending of the spleen and stomach when facing some difficult cases in clinic.