从《金匮要略》悟消渴之机

Pathogenic analysis of Xiaoke in Jingui Yaolue

消渴的理论基础源自《黄帝内经》,是在先天禀赋不足的基础上加之后天失养、饮食膏粱厚味、七情过度化火,导致五脏虚实寒热失调。消渴的辨证治疗始于《金匮要略》,笔者深入研习《伤寒杂病论》,悟仲景消渴之论,并结合临床治疗经验,提出消渴之病根在少阴,厥阴为调控,病性为寒热错杂或寒凝;从病变之层面来看,有气与精的不同,病久多至精之层面;从肾、肝入手运用经方治疗消渴可取得很好的临床疗效,并附3则运用经方治疗消渴病案加以分析。

According to Huangdi Neijing,xiaoke is a result of imbalances of cold and heat in the five organs caused by,in addition to inborn deficiency,improper diet(large quantities of sweets,fatty or greasy foods and alcohol)and emotional disturbances(stress,anxiety or depression).Treatment of xiaoke was firstly recorded in ZHANG Zhongjing’s Jingui Yaolue.Based on the study of Shanghan Zabing Lun along with clinical experience,the author proposes that xiaoke has its root cause at Shaoyin and is manifested at Jueyin.The nature of the disease is mixed hot and cold evil or suspended cold evil.It develops at two levels-qi and Jing(essence),with prolonged illness reaching Jing;using classic formulas to treat xiaoke from kidney and liver can achieve great clinical effects.At the end of the article,three typical cases and analysis of cases are attached.