从虚劳的方证分析来思考综合辨证

Study of comprehensive diagnosis and treatment on the basis of prescription and syndrome of consumptive disease

首先,对虚劳的概念与范围做了简单的梳理回顾,重点分析了后世对《金匮要略》中虚劳方证的3点困惑,并认为需要重新认识虚劳的病机和辨证方法。其次,通过分析提出脏腑阴阳辨证的局限性与虚劳病机的复杂性之间的矛盾是后世对虚劳方证分型不一致的重要原因,并着重引入一气周流和一元盈亏理论来试图解决这个问题。最后,在这2种理论的基础上提出了综合辨证的思路:即先通过一元盈亏理论判断元阳元阴偏颇盈亏的情况,再从一气周流角度判断人体气化的升降出入的障碍点,最后定位到某脏腑的阴阳偏盛。该综合辨证思路不仅可以用于虚劳病,而且可以在其他一般疾病上尝试使用。

Firstly,the paper made a brief review on the concept and range of consumptive d isease,emphatically analyzed the perplexities about prescription and syndrome of consumptive disease recorded in Golden Chamber.The authors suggested that it is necessary to rediscover its pathogenesis,diagnosis and treatment. Secondly,the authors found the key of the inconsistent typing of the disease was the contradiction between the limitation of zang-fu,yin-yang differentiation and the complexity of the pathogenesis,so they introduced the theories of Yiqizhouliu and Yiyuanyingkui to solve the problem. Finally,comprehensive ideas of diagnosis and treatment were proposed. Based on the theory of Yiyuanyingkui,the doctor could judge the deficit and reserve of original yin and yang. From the perspective of the theory of Yiqizhouliu,the doctor could determine the fault of qi transformation,then decide yinyang's excess trend in some certain organs. Such comprehensive thinking can not only be applied to consumptive disease,but also can be used in treating other general diseases.