论《金匮要略》辨证体系中的明线与暗线

Discussion of Bright and Dark Lines in Syndrome Differentiation System in Synopsis of Golden Chamber

文章依据《金匮要略》原文,归纳书中疾病辨证体系明暗两线,从疾病部位的角度构建的脏腑经络辨证体系为明,包括经络传于脏腑、经络脏腑同病、脏腑相传、脏腑传于经络四种形式;从物质病理改变角度构建的气津液血辨证体系为暗,包括辨治外感温热病的卫气营血传变和辨治内伤杂病的气水血传变两种形式。《金匮要略》中的明暗两线是后世辨证体系的中心脉络,众多医家从病变部位和物质病理改变两个方面丰富和补充了《金匮要略》脏腑经络辨证体系和气津液血辨证体系。把握《金匮要略》辨证体系的明暗两线,对于临床诊疗具有重要指导意义。

The direct and implied clues of syndrome differentiation system are concluded from Synopsis of Golden Chamber.The syndrome differentiation system of Zang-fu viscera and meridians constructed from the angle of disease location is direct,including four forms:disease of meridian are transmitted to the zang-fu viscera,diseases of viscera and meridians occur at the same time,diseases of viscera are transmitted to the meridians.The syndrome differentiation system of Qi,body fluid and blood constructed from the angle of pathological material,it is including the syndrome differentiation system of Defense-Qi-nutrient-blood system and the syndrome differentiation system of Qi,water and blood.Many doctors have enriched and supplemented the syndrome differentiation system of Zang-fu viscera and meridians and the syndrome differentiation system of Qi,body fluid and blood in Synopsis of Golden Chamber r from the two aspects of lesion location and material pathological changes.The direct and implied clues of syndrome differentiation system can be used to guide clinical practice.