“胃家实”及三承气汤运用辨析

Differentiation and Analysis of"Wei Jiashi"and Exploration of the Application of Three Chengqi Decoctions

“胃家实”作为阳明病提纲,意义重大的同时也颇具争议。本文基于阳明胃肠的生理机制揭示“胃家实”本质,并进一步分析“胃家实”病机治法,又据此探讨三承气汤之鉴别运用、“燥屎”与大小承气汤辨证关系及“胃家实”与“脾家实”的内在联系。从而提出“胃家实”属于正阳阳明病提纲,是阳明胃肠“更虚更满”机制紊乱而形成的一种病理状态。

As an outline of Yangming disease,"Wei Jiashi"is of great significance and controversial at the same time.Based on the physiological mechanism of Yangming's gastrointestinal tract,this article reveals the es⁃sence of"Wei Jiashi",and further analyzes the pathogenesis and treatment of"Wei Jiashi".Based on this,it dis⁃cusses the differential use of the three types of Chengqi Decoctions,the dialectical relationship between"dry excre⁃ment"and Da and Xiao Chengqi Decoctions,and the internal relationship between"Wei Jiashi"and"Pi Jiashi".Therefore,it is pointed out that"Wei Jiashi"belongs to the outline of Zhengyang Yangming disease,which is a pathological state formed by the disorder of the mechanism of"more deficiency and fuller"in Yangming stomach and intestines.