《黄帝内经》寝汗证治探析

Discussion on syndrome and treatment of night sweats in Huangdi Neijing

文章从病机司属、证治剖析、方药解说、病变机转、验案举例5个方面对《黄帝内经》寝汗进行探析,得出寝汗之病,是因心肾之阳被寒痰冷饮所伤而致,常以夜寐盗汗为其特殊表现,多伴有乏力少气、身重腹痛、胫肿胸痛、手足逆冷、耳聋腰痛、失精纳少、骨痛阴痹等寒水留结、风虚劳气之证。病变日久,积寒累及营血,可现肾积奔豚病、骨痹、骨极病。在治疗上首选《外台秘要》乐令黄芪汤,以补五脏六腑之虚损、化表里内外之痰饮。并根据精血虚损之不同程度,寒饮留结之不同部位,可辨证选用丸、散、膏、汤,以除寒水留结、风虚劳损之态。

This article investigated night sweats in Huangdi Neijing from five aspects: discussion of pathogenesis, explanation of treatment based on syndrome differentiation, prescription explanation, change of pathology and illustration of medical cases. This disease, marked by perspiration during sleep, is due to impairment of kidney yang and heart yang by cold phlegm and cold fluid. It is generally accompanied by symptoms of retention of cold water, invasion of wind and deficiencyconsumption, such as weakness and panting, general heaviness and abdominal pain, swelling tibia and chest pain, cold hands and feet, deafness and back pain, loss of essence and anorexia, bone pain and yin impediment. If the disease persists for a long time, the ying-blood will be involved, resulting in bentun, bone impediment and bone exhaustion. For treatment, Leling Huangqi Decoction in Waitai Miyao is used to nourish the five zang-organs and six fu-organs and resolve phlegm and fluid in both interior and exterior. According to the degrees of essence-blood deficiency and locations of cold fluid, different forms of prescription, such as pills, powder, ointment and decoction can be used to remove the retained cold water, expel wind and nourish deficiency.