“饮一溲二”病名病机浅析

Brief interpretation on the disease′s name and pathogenesis of"drinking little but urinating much"

“饮一溲二”首见于《黄帝内经》,是“肺消”的主要症状,病机为心移寒于肺。后世医家对其所属病名莫衷一是,各以“上消”“下消”“肺消”或“肾消”称之;病机上亦有较多发挥,燥火、寒热相兼或虚寒是主要病性,心、肺、肝、肾是主要病位,如喻嘉言强调“心肺燥热”、郑钦安主张“厥阴风火”、张从正阐明“心肺寒热”、楼英揭示“肺肾寒热”、黄元御提出“水寒土湿”。通过分析各家理论和相关方药、医案,本文认为“饮一溲二”可归“肾消”,肺肾虚寒为其基本病机,同时,亦应充分考虑脏腑相传、虚实夹杂、寒热转化等问题。本文总结并梳理中医古籍中的“消”病理论,为现代防治糖尿病启发思路。

First recorded in Huangdi Neijing,"drinking little but urinating much"is the main symptom of"Feixiao",of which the pathogenesis is heart transferring cold to lung.Many later traditional Chinese medicine doctors have worked and brought different expositions on the disease′s name,"Shangxiao","Xiaxiao","Feixiao"or"Shenxiao"are used respectively.In regard to the pathogenesis,dryness-fire,simultaneous occurrence of cold and heat or deficiency-cold are supposed to be the main properties of the disease,while heart,lung,liver,and kidney are the core disease locations.For example,YU Jiayan emphasized"dryness-heat in heart and lung",ZHENG Qin′an advocated"wind-fire of Jueyin",ZHANG Congzheng expounded"cold with heat in the heart and lung",LOU Ying revealed"cold with heat in the lung and kidney",and HUANG Yuanyu proposed"cold in kidney with dampness in spleen".By analyzing the theories of different schools of traditional Chinese medicine and related prescriptions or herbs and medical records,"drinking little but urinating much"could be attributed to"Shenxiao",and"deficiency-cold in lung and kidney"could be its basic pathogenesis,and meanwhile the cross-transmission of zang-fu viscera,intermingled deficiency and excess as well as inter-transformation between cold and heat should be considered adequately.This paper summarizes and sorts out the theories of"Xiao"disease in ancient literature,so as to provide new ideas for the modern prevention and treatment of diabetes.