从津液气化论发汗、利尿法的对立性与相通性

Discussion on Homology of Diaphoresis and Diuresis from Qi Transformation of Body Fluid

汗、尿是人体津液排泄的两个主要途径,由此衍生出发汗、利尿两大治疗法则。传统观念多认为,汗出于表,尿渗于下,二者分消津液,相互独立。本文详细探讨了汗、尿的津液来源及气化输布途径,认为汗、尿之间的关系是津液同源,藏于州都;上疏下利,气机互通。其中,肺的宣发肃降、膀胱经腑的气化是共司汗、尿排泄的枢纽。发汗可以宣发肺气、开太阳之气,从而有利于肺气肃降、太阳之气下还可以通利膀胱,调节尿液,既能利尿、又能止尿;利尿可以推动膀胱气化,使津气上还于肺、外达于表,调节汗液,既可发汗、又可止汗。因此,通过这一关系可以打破发汗、利尿法之间的对立,拓展小便证候、汗证的治疗方法。

Sweat and urine are the two main ways of body fluid metabolism,from which two therapeutic principles of diaphoresis and diuresis are derived.The traditional idea is that sweat is excreted from the skin and urine is excreted from the Bladder.They accomplish body fluid discharge in different ways.In this paper,the source of body fluid and the route of gasification and distribution of sweat and urine were discussed in detail.It is believed that sweat and urine all come from the Bladder,and although their Qi movement is respectively upward and downward,they communicate with each other.The dispersing and descending functions of the Lungand the Qi transformation of Bladder is the key points of regulating sweating and urination.Sweating can release Lung Qi,and make Baldder meridian unobstructed,so the Lung Qi and Bladder meridian can descend normally to regulate the urine of Bladder,which can not only diuresis,but also stop urination.Diuresis can promote the Qi transformation of Bladder,so that the body fluid and Qi can reach to the Lung and Fur,so as to achieve the effect of sweating or antiperspiration.Therefore,through this relationship,we can break the opposition between diaphoresis and diuresisso as to expand the treatment of urine syndrome and sweat syndrome.