从《伤寒论·平脉法》第32条谈中焦寒邪的上逆与下溜

On ascending counterflow and descending slide of middle energizer cold base on item 32 in Shanghan Lun· Pingmai Fa

宋本《伤寒论·平脉法》第32条论述了中焦虚寒的证候特点及寒气相抟累及少阴下焦的问题。因脾胃阳虚、升降失常,中焦寒邪并非一成不变滞留于中焦,还有上逆或下溜之势,因此分析中焦虚寒证,除立足于中焦脾胃的病位外,还应综合考虑阳气虚衰之程度、感受寒邪之轻重、水湿停聚之多少、病势发展之上下四方面。深入理解中焦寒邪的致病特点及中焦虚寒证候演变规律,对于指导临床实践,具有十分积极的现实意义。

Item 32 in Shanghanlun （Treatise on Cold Damage Diseases, Edition of Song Dynasty ） discussed the characteristics of middle energizer deficiency cold pattern and cold qi affecting lesser yin lower energizer. Due to spleen-stomach yang deficiency and abnormal ascending and descending, middle energizer cold does not always stagnate in middle energizer, but has tendency of ascending counterflow and descending slide. Therefore, the analysis of middle energizer deficiency cold pattern should comprehensively consider the degree of deficiency and debilitation of yang qi, severity of cold pathogen, amount of water-dampness stagnation, and disease tendency besides standing on disease location of spleen and stomach in middle energizer. Deep understanding of pathogenesis characteristics of middle energizer cold and evolvement rule of middle energizer deficiency cold pattern has positive significance in guiding clinical practice.