《伤寒论》少阳与脾胃关系之探析

An analysis of the relationship between Shaoyang and spleen-stomach in Shanghan Lun

少阳与脾胃关系密切。少阳相火温煦推动全身脏腑和精气血津液的运行,脾胃为“本”与“枢”,脾提取饮食中的津液精华不断补充人体精气,脾升胃降既推动了脏腑气机运动,又能制约脏气太过。脾胃气化和枢转过程对少阳相火的生发与不耗散、敷布畅达等运行有重要影响,而同时少阳相火对脾胃的阳气起到了支持作用,推动了脾胃中枢的枢转运行。脾胃化生的营卫充斥于表里之间,流布于三焦上下,而少阳又是营卫出入的枢纽。在发病机制上,脾胃虚弱容易引起少阳病,脾胃的状态能决定少阳病的传变和预后。少阳病变也会影响脾胃状态,若少阳邪结,邪气郁在表里之间不能透达而成压力,这种压力容易内迫阳明造成喜呕,甚至干呕不能食。脾胃不健则少阳病更甚,少阳郁结又反过来影响脾胃功能,形成恶性循环。研究还发现《伤寒论》观察到的少阳病与脾胃病的病愈时辰在六气上相关。研究通过梳理中医经典《伤寒论·少阳病篇》,探究少阳与脾胃在发病机制上的相关性,提示临床在治疗少阳病的同时不能忽视脾胃的状态。

Shaoyang(少阳)is closely related to the spleen and stomach.Ministerial fire of Shaoyang can warm and stimulate the operation of the whole-body viscera and Qi(气),blood and body fluid.Spleen and stomach is the“root”and the“pivot”.Spleen extracts body fluid essence in food and drink to constantly supplement human essence,and spleen and stomach ascending and descending not only promotes viscera Qi activity,but restricts it also.The state of the spleen and stomach,its Qi transformation and movement process have an important impact on the operation of ministerial fire of Shaoyang.At the same time,ministerial fire of Shaoyang also plays a supporting role in the Yang Qi of the spleen and stomach,promoting the pivot operation of the spleen and stomach.Ying Qi(营气)and Wei Qi(卫气)is generated by the spleen and stomach.They are filled between the Exterior and Interior,distributed in the triple energizer,and Shaoyang is the hub of Ying Qi and Wei Qi.In the pathogenesis,the weakness of spleen and stomach easily causes Shaoyang disease.The state of spleen and stomach can determine the transmission and prognosis of Shaoyang disease.On the other hand,Shaoyang disease will also affect the state of spleen and stomach.If Shaoyang pathogens agglomerating and pathogenic Qi depression cannot penetrate between the exterior and interior,it will cause pressure,which is easy to force Yang Ming and cause nausea,or even retching and can't eat.If the spleen and stomach are not healthy,Shaoyang disease will be more serious.Shaoyang depression in turn affects the function of the spleen and stomach,forming a vicious cycle.It is also found that the recovery time of Shaoyang disease is related to the recovery time of spleen and stomach diseases in the Six Qi,which has been observed by the Treatise on Cold Damage Diseases.Through combing the classic work of traditional Chinese medicine Shanghan Lun-Shaoyang disease,this paper explores the correlation between Shaoyang and spleen and stomach in the pathogenesis,suggesting that the state of spleen and stomach cannot be ignored while clinical treatment of Shaoyang disease.