探析《医学启源》和《中藏经》中脏腑辨证理论之差异

Detailed probe into the differences in the theory of visceral syndrome differentiation in Medical Origin and Zhongzangjing

系统论述《医学启源》与《中藏经》关于脏腑辨证理论体系的内涵差异,明晰二者在论述上的细微差别,完善金元以前脏腑辨证理论体系,从而提高对临床诊治的指导作用。本文主要通过比较法和文献分析法在脏腑辨证基础上对十二脏腑论述分别进行了详细比对,两著作在脏腑辨证体系框架建立方面一脉相承,在内容论述上有继承有创新,辨证分类上以“虚实寒热生死逆顺”为纲,明确了临证审查要点。具体而言,差异主要体现在论述相异12处、论述相近69处、论述有无1处等三方面;从脏腑而言,不同主要体现在肝10处,胆4处,心13处,小肠4处,脾10处,胃8处,肺11处,大肠1处,肾18处,大肠2处,三焦1处,心包络0处。相比《中藏经》,《医学启源》在论述上用词更为准确精炼,在辨证分类上更为全面详细。厘清二者间的异同,有助于加深对易水学派的理解,对后世以脏腑辨证为专题研究也提供了先导作用,同时有利于后学者临床诊治水平的提高。

This paper systematically discusses the connotation differences between the"Medical Origin"and the"Zhongzangjing"on the theory system of visceral syndrome differentiation,clarifying the nuances of the two in the discourse,and perfecting the theory system of visceral syndrome differentiation before Jin and Yuan dynesties,thus improving the guiding role of clinical diagnosis and treatment.In this paper,the method of comparative analysis and the literature analysis were used to compare the contents of the viscera and the syndrome differentiation on the content of the 12 viscera.The 2 books were in the same line in the establishment of the framework of the system of visceral syndrome differentiation.In the content,there were inheritance and innovation.The dialectical classification was based on the principle of“virtual reality,cold and heat,life and death,and rectification”.Specifically,the differences are mainly reflected in the 3 aspects:discussion differences(12),similar discourse(69),and discuss whether there is(1).From the viscera,the difference is mainly in the liver 10,4 in the gallbladder,13 in the heart,4 in the small intestine,10 in the spleen,8 in the stomach,11 in the lung,1 in the large intestine,18 in the kidney,2 in the large intestine,and 1 in the triple focus,0 in the heart envelope.Compared with the Zhongzangjing,Medical Qrigin,the discussion is more accurate and refined in terms of discourse,and is more comprehensive and detailed in dialectical classification.Clarifying the similarities and differences between the 2 will help to deepen the understanding of the Yishui School,and provide a leading role for the later studies on the diagnosis of viscera.It is also conducive to the improvement of the level of clinical diagnosis and treatment of post-scholars.