从“阳明系统”论五体痿的病位及病机

Discussion on the Location and Pathogenesis of Wuti Flaccidity From"Yangming System"

阳明系统包含脾、胃、阳明经脉,在五体痿形成过程中扮演核心与纽带的角色。首先阐明“治痿独取阳明”之病位“阳明”当是指阳明系统,继而从3个角度综合论述五体痿的病机。(1)邪气侵犯脾胃致痿:湿气外袭、饮食肥腻、偏嗜五味、思虑过度,能竭乏脾胃之气,使气血不足难以滋养筋骨,五体痿渐生。(2)脾胃内虚致痿:土不生金,肺脏难以布散精微养四肢,久成痿躄;土亏不能化精,可致肾中精亏髓乏而骨痿无力;土虚引发肝血亏虚,可渐发筋痿;若脾胃亏虚,则心血无源,故而弛纵难行,脉痿由生。(3)阳明经虚弱或经气不通,则宗筋不能受其濡养,引发筋纵而肢体无力而生痿。因此,阳明系统当为五体痿的病位核心,其运化、传导之职失司是五体痿的病机关键。

Yangming system includes spleen,stomach and Yangming meridians,which plays the core and the bond role in the formation of Wuti flaccidity.This paper first points out that"Yangming",the disease position of"treating flaccidity through Yangming meridian"refers to Yangming system.Then the pathogenesis of Wuti flaccidity is discussed from three aspects.(1)Evil Qi invades the spleen and stomach and causes flaccidity:external attack of moisture,greasy diet,partial preference for five flavors,excessive thinking,can exhaust the Qi of the spleen and stomach,make it difficult to nourish muscles and bones due to insufficient Qi and blood,and Wuti flaccidity gradually arises.(2)Flaccidity caused by deficiency in the spleen and stomach:the soil does not produce gold,the lungs are difficult to spread,and the essence can’t nourish the limbs,resulting in flaccidity for a long time;soil deficiency can not change essence,which can lead to essence deficiency in kidney,lack of marrow and bone weakness;soil deficiency causes liver blood deficiency,which can gradually lead to muscle flaccidity;if the spleen and stomach are deficient,no source of heart blood,so it is difficult to relax,and the pulse is flaccid.(3)If the Yangming meridian is weak or the meridian Qi is blocked,the Zongjin can't be nurtured by it,which leads to muscle longitudinal and limb weakness,flaccidity happened.It can be seen that the Yangming system should be the core of disease location of Wuti flaccidity,and the key to the pathogenesis of Wuti flaccidity is the loss of function of its transportation and transmission.