《伤寒论》病机比较推测思辨理论探析

On the Theory of Comparing Pathogenesis in Treatise on Febrile Diseases

[目的]通过对脉证征象进行比较推测,分析《伤寒论》中病机比较推测的思辨方式。[方法]通过对《伤寒论》原文进行客观全面的探析,包括根据治疗之后药效反应、相似之中有不相似之症、应出现之脉症未出现和不应出现之脉症出现、大小便症状表现、小便利否、厥热的程度和时间,以及阴性脉证推测病机等,对《伤寒论》中病机比较推测的思辨理论进行详细阐释。[结果]《伤寒论》中非常重视病机阐释,其原文中便有丰富的病机比较推测的语言文字描述。另外,张仲景认识病机的方法也是多种多样的,通过其治疗之后的药效反应、脉症推理、二便合参、药物试探、厥热变化及阴性脉证等多方面比较推测病机的思辨理论颇具特色,值得深入研究。[结论]对《伤寒论》中病机比较的推测思辨理论进行详细阐释,对于《伤寒论》病机理论和中医学辨证理论的研究应用,以及临床疗效的提高,均具有重要的指导价值。

[Objective] To reveal the speculative way of comparing and inferring pulse signs and analyzing the pathogenesis in Treatise on Febrile Diseases.[Methods] Through an objective and comprehensive analysis of the original text of Treatise on Febrile Diseases, including the response to the drug effect after treatment, the dissimilar symptoms among similarities, the disappearance of pulse symptoms that should appear and the appearance of pulse symptoms that should not appear, and the manifestations of urine and bowel symptoms, patency of urination, the degree and time of fever, and the speculative pathogenesis of negative pulse syndrome, etc., it explained in detail the speculative theory of pathogenesis comparison in Treatise on Febrile Diseases. [Results]Treatise on Febrile Diseases attached great importance to the interpretation of pathogenesis, and the original text contained wealth of language and text descriptions of relatively speculative pathogenesis. In addition, ZHANG Zhongjing had a variety of ways to understand the pathogenesis. The pathogenesis could be inferred from various aspects such as drug effect after treatment, pulse reasoning, combination of urine and feces, drug trials, fever changes, and negative pulse. The speculative theory that compared the pathogenesis of syndromes and other aspects was quite distinctive and was worthy of in-depth study. [Conclusion] The detailed explanation of the theory of pathogenesis comparison and speculation in Treatise on Febrile Diseases has important guiding value for the research and application of pathogenesis theory of Treatise on Febrile Diseases and traditional Chinese medicine syndrome differentiation theory, as well as the improvement of clinical efficacy.