“开合枢”的哲学内涵及“枢病”理论在中医学中的应用

Philosophical connotation of 'opening and closing pivot' and the application of the theory of 'pivot disease' in traditional Chinese medicine

在对《伤寒论》《黄帝内经》等经典中存在的如:"风则伤卫,寒则伤荣"的机制问题?六经病的论述中为何只提"中风""伤寒"两种外邪?小柴胡汤的条文中"伤寒五六日中风",为什么"伤寒"与"中风"并提?半夏泻心汤的方证机制就只限于"痞证""寒热错杂"?桂枝麻黄各半汤系列方的作用机制是什么,临床如何应用?《素问·疟论》中对于疟病的论述有何实际内涵"等问题的思考过程中,发现"开合枢"理论对于中医经典具有重要的指导和揭示意义。因此,文章首先从"开合枢"哲学原理的阐释入手,发掘其内涵,而后梳理《黄帝内经》《伤寒论》中常见的与"枢"相关的疾病,分为"表之枢病""半表半里之枢病""里之枢病""全体之枢病"4种,分析其相关的辨治机制,并对上述问题进行阐释,以期逐步形成中医学"枢病"的理论体系。

What is the mechanism of ‘the wind hurts the Wei, the cold is hurt Ying＇？. In the discussion of six meridians syndrome, why does only refer to ‘stroke＇ and ‘typhoid＇ two kinds of external evil？ Why does refer to ‘typhoid＇ and ‘stroke＇ at the same time in the clause of Xiaochaihu Decoction？ Are the indication only abdominal distension and intermingled cold and heat of Banxia Xiexin Decoction？ What is the mechanism of action of Guizhi Mahuang each half series party and how to carry out clinical application？ What is the actual connotation on malaria in Suwen Nuelun in the classic？ These questions were discussed in this paper. Due to the thinking of the above problems which are existing in classics such as Shanghan Lun and Huangdi Neijing, we discover that the theory of ‘opening and closing pivot＇ has important guiding and revealing significance for the classics of traditional Chinese medicine. Therefore, this paper begins with the interpretation of the philosophical principle of ‘opening and closing pivot＇ and explores its connotation. Later, we arranges the common diseases associated with ‘pivot disease＇ in the Huangdi Neijing and Shanghan Lun. And we will divide these diseases into four kinds, including the ‘pivot disease in the table＇, ‘pivot disease in half exterior and interior part＇, ‘pivot disease in the interior＇, ‘pivot disease of the whole＇. We also analyze the mechanism of these diseases and elaborate on the problems, to gradually form a ‘pivot disease＇ of TCM theory system.