彭子益《圆运动的古中医学》少阳病证治思想探析

Analysison PENG Ziyi's syndrome differentiation and treatment thought of Shaoyang disease(少阳病)in Circular Movement in Ancient Chinese Medicine

从少阳病治疗宜忌、变证及用方三方面探析彭子益《圆运动的古中医学》中少阳病的证治思想,为诊治少阳病提供了新的思路。其认为少阳居于半表半里,外为荣卫,里为脏腑。若荣卫表气为风寒所伤则其气郁,表郁则里亦郁,使胆之相火不降、三焦相火不升,形成寒热往来之象,其热可传胃腑,其寒可传肝脏。中气如轴,四维如轮,气机升降依赖中焦运动,脾胃中气不能斡旋气机则胆火更不降、三焦相火愈不升。治疗少阳病汗、下、温法皆不适宜,当重视和解以发挥少阳枢纽作用,重视补中以促进脾胃中轴运动,同时兼顾变证。小柴胡汤兼顾和解、补中,其合承气汤则能清胃腑热,合温木气药则能散肝寒,凡为少阳病衍变者,皆能以此方化裁。

The syndrome differentiation and treatment thought of Shaoyang disease(少阳病)in PENG Ziyi's Circular Movement in Ancient Chinese Medicine are analyzed from treatment taboos,syndromes changes and prescriptions,which provides a new idea for the diagnosis and treatment of Shaoyang disease.PENG believed that Shaoyang(少阳)lived in half outside and half inside,with Rongwei(荣卫)outside and viscera inside.If Rongwei's external qi is injured by wind-cold,the qi will be stagnant,and the external stagnation will also be stagnant inside,so that the fire of the gallbladder does not descend,and the fire of Tri-jiao does not rise,forming the phenomenon of cold and heat exchange,the heat can be transmitted to the stomach,and the cold can be transmitted to the liver.The middle Qi is like a shaft,and the four dimensions are like a wheel.The rise and fall of Qi depends on the movement of the middle energizer.If the Qi in the spleen and stomach cannot mediate the normal operation of Qi,the gallbladder fire will not descend,and the fire of Tri-jiao will not rise.In the treatment of Shaoyang disease,sweating,lowering,and warming methods are not suitable,and attention should be paid to reconciliation to play the role of Shaoyang hub,and emphasis on supplementing the middle to promote the movement of the spleen and stomach axis,while taking into account the change of syndromes.Xiaochaihu Tang(小柴胡汤)takes into account reconciliation and invigorating the middle.Its combination with Chengqi Tang(承气汤)can clear heat in the stomach and intestines,and when it is combined with warm liver qi medicine,it can dispel cold in the liver.Any disease evolved from Shaoyang disease can be cured by modified Xiaochaihu Tang.