基于张仲景津液理论探讨小便利的内涵及意义

Research on Connotation and Significance of Smooth Urination Based on Zhang Zhongjing′s Body Fluids Theory

津液理论是张仲景医学理论的重要组成部分,小便利作为仲景著作中直观、动态反映津液盈虚通滞状态的要点,向来为医家所重视。作为生理现象的小便利,是指排尿通畅而无困难,其可提示机体气化功能健运或恢复,水津代谢功能正常或复常,津液充足或复得的临床意义。作为病理现象的小便利,是指排尿过度通畅,一般伴有尿量及排尿频次较前明显增多的表现。其可反映脏腑功能失调或虚损所致的水津输泄过甚的病理机制。因此,小便利这一表现,能够直观、生动地反映机体津液输泄“通调”与“过通”两种状态。在临床实践中,须紧密结合疾病的伴见症、所处的病理阶段以及病情轻重等因素,对小便利的实质作出精准判断,以期更好地指导相关病证的辨治。

Body Fluid theory is an important part of Zhang Zhongjing′s medical theory.As a key point in Zhongjing′s works to intuitively and dynamically reflect the state of body fluid surplus,deficiency,smoothness,and stagnation,smooth urination has always been paid attention to by many physicians.As a physiological phenomenon,smooth urination refers to urination without difficulty,which can indicate the clinical significance of healthy movement or recovery of the body′s Qi transformation function,normal or righten water metabolism,and sufficient or recovery of body fluids.However,as a pathological phenomenon,it refers to excessive urination,usually accompanied by a significant increase in urine output and frequency.It can reflect the pathological mechanism of excessive water and fluid excretion caused by visceral dysfunction or deficiency.Therefore,the performance of smooth urination can intuitively and vividly reflect the two states of the body′s"regulative"and"excessive"Fluid drainage.In clinical practice,it is necessary to closely combine factors such as the accompanying symptoms of the disease,the pathological stage,and the severity of the disease,and to make accurate judgments on the essence of smooth urination,thus better guiding the diagnosis and treatment of related diseases.