基于气机升降出入的“六经病欲解时”阐释

Explanation of“Time to Subside Six-meridian Diseases”from Ascending,Descending,Exiting and Entering of Qi Movement

六经病欲解时是《伤寒论》中诊治疾病的重要理论,是天人相应理论的具体应用,从自然界气机升降出入对人体气机影响角度,阐释六经病欲解时。寅至辰时,自然界阳气初升,人体之气也随之升达,此时少阳经可借天时祛邪外出,如邪气较轻,人体可借初升之少阳之力鼓邪外出,症状减轻而“欲解”;反之,如邪气较盛,正邪旗鼓相当,相互交争,寒热往来等症状加重而“欲剧”。巳至未时,自然界阳气升发到顶点,人体之气也升发至体表,人体借天时之力鼓邪外出,太阳经证症状减轻而“欲解”;此时人体阳气浮于表,体内热力稍减,故太阳腑证诸症状减轻,也表现为“欲解”。申至戌时,自然界阳气开始收敛,人体之气随之收敛体内,体表阳气减少,故阳明经证热象稍减而“欲解”;阳气向体内聚集,在里之热邪被内收之阳所引动而发热加重,故阳明腑证“欲剧”。亥至丑时,自然界阳气收敛到一定程度后继续收敛入阴分,太阴是三阴病的开始,太阴脾虚寒是太阴病的主要机制,故阳气先到太阴助脾阳温化寒湿,调气升降,表现为“欲解”。子至寅时,自然界阳气敛降到极致,也即封藏,人体之气随之也封藏于里行温煦之功,故少阴寒化“欲解”;对于少阴热化证,此时阳气入阴,蒸腾阴液,且引动在里之邪热,故症状加重而表现为“欲剧”。丑至卯时,自然界阳气敛降到极点之后开始上升,人体之气随之开始升发,厥阴病多为寒热错杂证,如患者厥阴病寒多热少,疾病可借此阳气来复之机而减轻,表现为“欲解”;反之,如热多寒少,则此时阳气渐升可能会热上加热,导致病情加重表现为“欲剧”。

“Time to subside six-meridian diseases”is an important theory for the diagnosis and treatment of diseases in Treatise on Cold Pathogenic Diseases.This theory is a concrete application of the theory of correspondence between nature and human.This paper explains this theory of“time to subside six-meridian diseases”from the perspective of the influence of ascending,descending,exiting and entering of natural qi movement on the human qi movement.From Yinshi to Chenshi,yang qi in nature begins to rise,and qi of the human body also rises.At this time,Shaoyang meridian can take advantage of the opportune time and expel pathogen.If the pathogen is mild,human body may take advantage of power of Shaoyang meridian and expel pathogen,so the symptoms are relieved and“will be subsided”.On the contrary,if the pathogen is more exuberant,severe struggle between healthy qi and pathogen may aggravate symptoms such as spells of fever and chills which“will be exacerbated”.From Sishi to Weishi,yang qi of nature rises to the peak,and the qi of the human body also rises to the exterior of the body.The human body can take advantage of the opportune time and expel pathogen,and the symptoms of Taiyang meridian are relieved and“will be subsided”.At this time,yang qi of human body floats on the exterior,and the heat in the body is slightly reduced.Therefore,the symptoms of Taiyang Fu syndrome are reduced and“will be subsided”.From Shenshi to Xushi,yang qi in nature begins to converge,and qi of the human body converges in the body,and yang qi on the body surface decreases.Therefore,the heat symptoms of Yangming meridian syndrome decrease slightly and“will be subsided”.Yang qi accumulates in the body,and the internal heat pathogen in the body is triggered by the internal accumulated yang.Fever is aggravated,so Yangming Fu syndrome“will be exacerbated”.From Haishi to Choushi,yang qi in nature continues to converge into yin aspect.Taiyin is the beginning of three yin diseases.Deficiency and cold of spleen of Taiyin is the main mechanism of Taiyin disease.Therefore,yang qi comes to Taiyin meridian first,assists spleen yang to warm and resolve cold and dampness,and regulates the ascending and descending of qi and“will be subsided”.From Zishi to Yinshi,yang qi of human body converges extremely and is stored inside,and the qi of the human body is also stored inside to warm the body,so Shaoyin cold“will be subsided”.As for Shaoyin heat syndrome,at this time,yangqi enters yin,streams yin fluid and triggers the internal heat pathogen,so the symptoms are aggravated and“will be exacerbated”.From Choushi to Maoshi,yang qi in nature converges extremely and begins to rise,and the qi of the human body also begins to rise.Jueyin diseases are mostly cold and heat in complexity syndrome.For example,patients of Jueyin disease with more cold and less heat can take advantage of the recovery of yang qi to be relieved and“will be subsided”.On the contrary,if more heat and less cold can raise yang qi and increase heat,and“will be exacerbated”.