《伤寒论》脾胃病治法探析

Spleen and stomach diseases in Treatise on Febrile Diseases

中医认为,脾为后天之本,气血生化之源。脾胃虚衰,生化无源,产生虚证、寒证;邪实壅于中焦,正邪相争,则为实证、热证;正气已虚,然邪仍恋战,则发展为虚实夹杂证、寒热错杂证;脾为生痰之源,脾虚运化不力则致痰阻气逆证。仲景在治疗外感病过程中运用五法治疗脾胃病:温补脾胃、苦寒直折、寓清于补、攻补兼施、降逆化痰,有效提升脾胃运化功能,恢复气机升降出入,成功截断病程,促进痊愈。《伤寒论》对脾胃病的治法,体现了仲景辨证论治、治病求本的思想。

In Traditional Chinese Medicine,spleen is the origin of the acquired constitution,the source of qi and blood.Spleen asthenia and biochemical passive,resulting in deficiency and cold syndrome;pathogenic factors invade middle-jiao and struggle with vital qi leads to excess syndrome and heat syndrome;Vital qi deficiency while pathogenic qi prevailing makes deficiency accompanied with excess syndrome or intertwist of cold with heat syndrome;as spleen being source of phlegm,spleen asthenia produce phlegm causing the syndrome of blocked phlegm and adverse rising of qi.During the treatment of exogenous disease,ZHANG Zhongjing applies Five Methods of spleen and stomach diseases：warming and tonifying the spleen and stomach;usingdrugs of bitter and cold,invigoration with clearing heat;simultaneous elimination and reinforcement;lowering the adverse rising energy and eliminating phlegm,which can enhance the spleen and stomach＇s function of transportation and transformation,harmonize qi movement of upward,downward,inward and outward.The process of disease can be effectively cut off,promoting recovery.The erapeutic methods of spleen and stomach diseases in Treatise on Febrile Diseases embody ZHANG Zhongjing＇s idea of treatment based on syndrome differentiation,exploring the primary cause in treatment.