基于“水郁折之”探析《伤寒论》水郁治法

Treatment of Water Depression in Shanghan Lun Based on"Water Depression Being Treated by Inducing"

"水郁折之"原义为水气之运郁滞不畅,当以分利水郁之邪。《伤寒论》六经病中亦多见水郁之证,如太阳外感里饮证和太阳蓄水证;少阳枢机不利,饮停阳郁证;少阴之阳虚水泛证和阳虚有热、水气不利证等。"折之"者,伐而消之也,以分消、疏散水郁之邪。仲景涵水郁证于诸经之中,治法上虽有不同体现,均蕴含"折之"之义,如小青龙证之辛而散水法;五苓散证之化而行水法;真武汤证之温而利水法;生姜泻心汤证及茯苓甘草汤证之和胃消水法;十枣汤证、大陷胸汤证及牡蛎泽泻散证之泻而逐水法;茯苓桂枝甘草大枣汤证及茯苓桂枝白术甘草汤证之平冲降水法;猪苓汤证之育阴利水法;柴胡桂枝干姜汤证之和解枢机宣水法等。

The original meaning of"water depression being treated by inducing"is the stagnation of water qi,which should be treated by inducing diuresis.In six meridians disease of Shanghan Lun,the syndrome of water depression is also common,such as the syndrome of Taiyang Waigan Liyin and the syndrome of Taiyang Xushui;Shaoyang cardinal block,resulting in Yinting Yangyu syndrome;the syndrome of water overflowing due to yang deficiency and the syndrome of deficiency of yang with heat,stagnation of water qi in Shaoyang."Inducing"means separating and dispersing the pathogen of water depression by eliminating.Zhong Jinghan's"water depression"can be found in all channels.Although there are different manifestations in the treatment,they all contain the meaning of"inducing",such as Xiner Sanshui method of Xiaoqinglong syndrome;Huaer Xingshui method of Wuling Powder syndrome;Wener Lishui method of Zhenwu Decoction syndrome;Hewei Xiaoshui method of Shengjiang Xiexin Decoction syndrome and Fuliang Gancao syndrome;Xieer Zhuishui method of Shizao Decoction syndrome,Daxianxiong Decoction syndrome and Muli Zexie Powder syndrome;Pingchong Jiangshui method of Fuling Guizhi Gancao Dazao Decoction syndrome and Fuling Guizhi Baizhu Gancao Decoction syndrome;Yuyin Lishui method of Zhuling Decoction syndrome;Hejie Shuji Xuanshui method of Chaihu Guizhi Ganjiang Decoction syndrome.