从三阴表证探讨《伤寒杂病论》腰痛治法

Discussion on Low Back Pain Treatment in Shang Han Za Bing Lun from Three Yin Manifestations

腰痛症牵涉疾病广泛,病位较为复杂。张仲景在所著《伤寒杂病论》中提倡六经皆有表证,腰痛亦然。腰痛涉及三阴表证病机基本围绕阴寒凝滞肌肉、筋膜、骨节展开,并以温阳散寒作为治疗大法。根据发病部位可归纳为4类4法:病在太阴治以温脾散寒、化湿止痛,病在少阴治以温肾散寒、化饮通经,病在厥阴治以暖肝养血、温经通脉,多经表证则治以通阳宣痹、散寒化湿。

Low back pain involves a wide range of diseases and has complex disease locations.ZHANG Zhongjing advocated in his book Shang Han Za Bing Lun(Treatise on Cold Damage and Miscellaneous Diseases)that all six meridians have manifestations,including low back pain.Low back pain involves the pathogenesis of the three yin manifestations,which is mainly about the stagnation of yin and cold in muscles,fascia,and joints,and the main treatment method is warming yang and dispersing cold.According to the location of the disease,it can be classified into four categories and four methods:in the treatment of Taiyin,warming the spleen and dispelling cold,and resolving dampness and relieving pain;in the treatment of Shaoyin,warming the kidney and dispelling cold,and resolving dampness and unblocking meridians;in the treatment of Jueyin,warming the liver and nourishing blood,and warming meridians and unblocking collaterals;and in the treatment of multiple meridians,promoting yang and diffusing impediments,and dispelling cold and resolving dampness.