《伤寒论》脾胃分治与合治思想探析

Exploration of the Academic Ideas of Separate and Combined Treatment of the Spleen and Stomach in the Treatise on Febrile Diseases

脾胃同居中土,生理相依,升降相因,共司纳运,斡旋气机;然脾胃又一脏一腑,一阴一阳,体用各殊。故《伤寒论》继承《内经》理论基础,针对其阴阳各异、体用各殊之特点,将脾胃之病于"辨太阴病脉证并治"与"辨阳明病脉证并治"两篇分而论治,设立不同的治则方药,治胃多用凉润、攻伐,治脾多用温燥、补益;亦不忘其生理相依、病理相及,太阴阳明相互传变,或脾胃相兼为病时,又设太阴阳明双解、辛开苦降、寒热平调诸法,异同兼顾,不失偏颇。为临床脾胃病的治疗提供思路及方法途径,使后世有理可循,有法可遵。

TThe two organs,the spleen and the stomach,are both located in the middle of the body and have a close physiological relationship,working together to maintain and regulate the movement of Qi,as well as the intake and digestion of food.However,the spleen and the stomach,one being an organ and the other a bowel,one being Yin and the other Yang,have different physiological properties and functions.Therefore,the book Treatise on Febrile Diseases inherits the theoretical basis of Inner Canon of Huangdi and addresses the different physiological characteristics of the two organs,namely the“identification of the pulse and evidence of Taiyang diseases and their treatment”and the“identification of the pulse and evidence of Yangming diseases and their treatment”,and deals with the pathologies of the spleen and the stomach respectively.The book also establishes different treatment principles and medicines for treating diseases of the spleen and stomach,with the stomach being treated mostly with cooling,moistening and attacking,and the spleen being treated mostly with warming and drying,tonifying.Meanwhile,the book also takes into account their close physiological and pathological links.When the pathologies of the spleen and stomach are transformed into each other or are concurrently diseased,various treatment methods such as the“Taiyin-Yangming double solution method”and the“use of pungent and bitter medicines together,or cold and hot medicines together”are provided,so that the differences and similarities are balanced without bias.The treatment methods provided in this book provide ideas and methodologies for the clinical treatment of spleen and stomach diseases,giving future generations of medical practitioners a rationale to follow and a method to follow.