辨十二经之头部汗出之“源”

To Differentiate the Source of Head Sweating of Twelve Meridians

[目的]论述"头部汗病"病位、病因、病机之源,总结"但头汗出"六经辨证论治体系。[方法]以"标本中气"理论体会《伤寒论》中"但头汗出"的相关条文,求证于临床医案,总结出辨"头部汗病"的特异性病位、病因、病机和方药。[结果]"但头汗出"其病位涉及十二经表、阳明里、少阳里、厥阴里;病因包括寒风、风热、湿、饮、燥;病机有十二经表湿里郁热证、阳明湿化太过证、少阳寒饮郁火和结胸、少阳伤寒兼厥阴里证、阳明热郁胸膈证、厥阴热极伤阴证;方药以"病证、病因、病位"之逆化裁茵陈蒿汤、柴胡桂枝干姜汤、栀子豉汤等经方。[结论]辨"头部汗病"需谨守"辨证四要素"及鉴别诊断,辨病因、辨病位、辨病机、辨方药,结合标本中气理论应用于六经辨证之中,方可见病识源,因势利导。

[Objective]To distinguish the etiology,pathogenesis, prescription of the ＂head sweating ＂,summarizing the six classics system.[Methods]The author analyzed the clinical experience by the theory of＂manifestation root cause and medial qi＂, comprehending Treatise on Febrile Diseases,and summarizing the specificity location, etiology, pathogenesis and prescription of the disease.[Results] The location of head sweating is superfacial of twelve meridians, inward of Shaoyang and Yangming and Jueyin;pathogeny is cold wind, wind heat, dampness, drink, dryness; Pathogenesis are ＂exterior dampness and pyrostagnant in 12 channels syndrome, excessive dampness of Yangming, Shaoyang cold and thoracic stagnated fire, simultaneous occurrence of syndromes in both Shaoyang and Jueyin, Yangming pyrostagnant, heat of Jueyin damaging blood ＂;Prescribing according to the characteristics of disease, etiology, disease location, for example Yin Chenhao Tang, Chai Hu Guizhi Ganjiang Tang, Zhi Zichi Tang. [Conclusion] Only grasping the main points of syndrome differentiation and differential diagnosis, identifying the cause, the position, the pathogenesis, the prescription,can we cure the ＂head sweating ＂.