《金匮要略》柔痉的再辨析

Re-differentiation ofSoft spasms in Synopsis of the Golden Chamber

由于历史背景的原因,仲景论治柔痉多从外感风寒入手,认为柔痉多由外感风寒过汗误治化热而来,瓜蒌桂枝汤为治疗柔痉一病的专方。而后世医家受温病学启发认为柔痉亦可由津液亏虚外感风热而发,瓜蒌桂枝汤非治疗柔痉之良方。通过分析原文与各家注释,旁参《伤寒论》中相关条文对《金匮要略》中柔痉的相关内容再次进行辨析,认为《金匮要略》中所论述的柔痉既可起于风寒误治,亦可源于津液亏虚直接外感风热,但其基本病机均为热盛津伤。而瓜蒌桂枝汤为治疗柔痉的主方,应当根据临床实际辨证用之。

Due to the reasons of historical backgrounds,Zhang Zhongjing on the treatment of Soft spasms mostly start from the external wind and cold,believes that the Soft spasms are mainly caused by the treatment of exogenous cold and excessive sweating,and the Gualou Guizhi Decoction is a special prescription for the treatment of Soft spasms.Physicians of later genera-tions were inspired by Science of Febrile Diseases to believe that Soft spasms can also be caused by body fluid deficiency and ex-ogenous wind heat,and the Gualou Guizhi Decoction is not a good remedy for treating Soft spasms.Analyzing the relevant contents of Soft spasms in the Synopsis of the Golden Chamber through the analysis of the original text and the notes of various schools,as well as referring to relevant original text in Treatise on Febrile Diseases and it is believed that the Soft spasms discussed in the Synopsis of the Golden Chamber can be caused by the mistreatment of wind and cold,and can also be derived from the direct ex-ogenous wind heat on the basis of body fluid deficiency But the basic pathogenesis is excessive heat damaging fluid.And the Gual-ou Guizhi Decoction is the main prescription for the treatment of Soft spasms,and it should be used according to clinical practice.