仲景通痹开痞疗胸痹中调营卫思想

Zhongjing's thought of regulating nutritive and defensive Qi in treating angina pectoris by alleviating pain and removing distension

《金匮要略·胸痹心痛短气病脉证并治第九》云“胸痹心中痞,留气结在胸,胸满,胁下逆抢心,枳实薤白桂枝汤主之,人参汤亦主之”。此处论述胸痹疾病过程中出现痞证的一组症状,一组症状往往蕴含一种病机,从今世方药理念看待,此条却设立虚实不同的两方,从仲景的角度却不然。仲景所著《伤寒杂病论》一书被后世分为《伤寒论》《金匮要略》两部分,承先贤思想,蕴含仲景的思维模式,联合起来才能完整学习仲景的辨证论治思维。凭仲景对脉象的记载解读胸痹病机之营卫失常,从营卫理论分析胸痹心中痞的成因,探索两方中仲景调营卫的思维。

The Ninth Chapter of Treatment of Angina Pectoris,Heart Pain,Shortness of Breath Disease in Jingui Yaolve says that angina pectoris is manifested by distension and stagnation of Qi in the chest.When there is fullness in the chest and hypochondrium,Zhishi Xiebai Guizhi Decoction and Renshen Decoction can be used to treat the disease.Here discusses a group of symptoms of distension syndrome in the process of angina pectoris,and a group of symptoms often contains a pathogenesis.From the present prescription concept,the above sets up different prescriptions for deficiency and excess syndromes,but not from the perspective of Zhongjing.Shanghan Zabing Lun,written by Zhongjing,is divided into two parts,Shanghan Lun and Jingui Yaolve,which inherit the thought of the sages and contain the thinking mode of Zhongjing.Only when they are combined can we fully learn Zhongjing's thinking of syndrome differentiation and treatment.Based on Zhongjing's record of pulse condition,the study interprets the pathogenesis of angina pectoris caused by disorder of nutritive and defensive Qi,analyzes the cause of the feeling of distension in angina pectoris from the nutritive and defensive Qi theory,and explores Zhongjing's thinking of regulating nutritive and defensive Qi.