《黄帝内经》膈中病脉证并治探析

Discussion on pulse syndrome and treatment of Gezhong Bing in Huangdi Neijing

文章从病机概览、方药解说、名候析疑、病变机转、证治举例5个方面对膈中病进行探析,得出膈中病因"忧恚寒热"四气和"动气"伤神,进而脾胃运化失司,气血化生不足,痰饮水湿之气弥漫胸膈所致,临床常见饮食不下、反酸烧心、短气、胸闷、心下痞坚等症,并与胸痹心痛病、腹满寒疝病、奔豚上气病、虚劳结气病、脚气冲心病等密切相关。在治疗上可选用《肘后备急方》五膈丸,并根据虚劳结气之不同程度,痰饮水气之弥漫部位,而酌情增损五膈、七气等方。

This article investigates Gezhong Bing from five aspects:overview of pathogenesis,explanation of prescriptions and herbs,clarification of names and manifestations,changes of pathology,and illustration of medical cases.This disease is due to worry,anger,cold,heat,climatic changes and examples of pathogenesis and treatment.It is concluded that the causes of Gezhong Bing are‘worry,angry,cold and heat’four qi and‘moving qi’hurt the spirit,which lead to dysfunction of the spleen and stomach in transformation,insufficient production of qi and blood,and diffusion of phlegm,fluid,water and dampens in the chest and diaphragm.The common clinical manifestations include inability to eat,acid regurgitation,heartburn,shortness of breath,chest oppression and epigastric oppression,etc.This disease is closely associated with chest impediment,heartache,abdominal distension,testicular pain,sensation of rising of qi due to Bentun,stagnation of qi due to deficiency-consumption and cardiac beriberi.This disease can be treated by Wuge Pill in Zhouhou Beiji Fang.According to the degrees of stagnation of qi due to deficiency-consumption,Wuge Pill and Qiqi Prescription can be modified in doses.