《伤寒论》烦证浅析

A Shallow Analysis of Dysphoria in Treatise on Cold Damage Diseases

太阳烦证有太阳本经郁热不宣导致的烦证和误汗、误吐、误下、误火攻导致的变证,太阳本经烦证有桂枝汤证、麻黄汤证、大青龙汤证和五苓散证,太阳病误治导致的变证有误汗、误吐所致栀子豉汤证、误下所致大陷胸汤证、误用火疗和下法所致桂枝甘草龙骨牡蛎汤证、误用汗、下所致干姜附子汤证和误用汗、下所致茯苓四逆汤证。阳明烦证有阳明热证、阳明实证和阳明变证,阳明热证为白虎加人参汤证,阳明实证为调胃承气汤证,阳明变证为栀子类方证和大陷胸汤证。少阳烦证有小柴胡汤证、大柴胡汤证、柴胡加龙骨牡蛎汤证、柴胡桂枝汤证和柴胡桂枝干姜汤证。太阴烦证有小建中汤证和甘草干姜汤证。少阴烦证有少阴寒化证和少阴热化证。厥阴烦证有寒极致烦证和热极致烦证。烦证总病机为热扰心神,但热有虚热、实热之分,临证须审证求因,根据不同病因,抓主证、辨病机,灵活审慎论治方可取得良效。

Taiyang dysphoria is either caused by the stagnated heat in Taiyang meridian,or is transmuted pattern caused by inappropriate sweating,accidental vomiting,erroneous administration of purgatives,and misuse of reinforcement. Taiyang meridian dysphoria includes syndrome of Cinnamon Twig Decoction,syndrome of Ephedra Decoction,syndrome of Major Green Dragon Decoction,and syndrome of Five Substances Powder with Poria. The transmuted patterns caused by the wrong treatment of Taiyang disease include syndrome of Gardenia and Soybean Decoction due to inappropriate sweating,and accidental vomiting,syndrome of Major Chest Draining Decoction due to erroneous administration of purgatives,syndrome of Cinnamon Twig and Licorice and Os Draconis and Concha Ostreae Decoction due to misuse of reinforcement and erroneous administration of purgatives,syndrome of Rhizoma Zingiberis and Aconite Decoction due to inappropriate sweating and erroneous administration of purgatives,syndrome of Frigid Extremities Decoction with Poria due to inappropriate sweating and erroneous administration of purgatives. Yangming dysphoria includes Yangming heat syndrome,Yangming excess syndrome,and Yangming transmuted pattern. Yangming heat syndrome is manifested as syndrome of White Tiger Decoction Plus Ginseng. Yangming excess syndrome is manifested as Stomach-Regulating and Purgative Decoction.Yangming transmuted patter is manifested as syndrome of Fructus Gardeniae Decoction Type. Shaoyang dysphoria is manifested as syndrome of Minor Bupleurum Decoction,syndrome of Major Bupleurum Decoction,syndrome of Bupleurum Decoction plus Os Draconis and Concha Ostreae,syndrome of Bupleurum Decoction plus Ramulus Cinnamomi,syndrome of Bupleurum and Cinnamon Twig and Dried Ginger Decoction. Taiyin dysphoria is manifested as syndrome of Minor Center-Fortifying Decoction,syndrome of Licorice and Dried Ginger Decoction. Shaoyin dysphoria includes syndrome of Shaoyin cold and syndrome of Shaoyin heat. Jueyin dysphoria includes dysphoria due to excessive cold and dysphoria due to excessive heat. The total pathogenesis of dysphoria syndrome is heat disturbing the mind and spirit,but the heat can be divided into deficiency heat and excess heat. The clinical syndrome must be examined for the cause. According to different causes,good results can be achieved by grasping the main syndrome,identifying the pathogenesis,and discussing the treatment flexibly and prudently.