河南中医2024，Vol.44Issue(7)：983-988,6.DOI:10.16367/j.issn.1003-5028.2024.07.0181
《伤寒论》上热下寒证浅析
An Analysis of Upper-Heat and Lower-Cold Syndrome in Treatise on Cold Damage Diseases
摘要
Abstract
Upper-heat and lower-cold syndrome belongs to a clinical syndrome with a mixture of deficiency and excess,and a complex pathogenesis.The basic pathogenesis is the abnormal ascending and descending of yin-yang qi,and the normal operation law of qi is blocked.It can be roughly divided into the dysfunction of the spleen and stomach in the middle energizer and the disharmony of liver and lungs.There is a phenomenon of upper relative stagnation and lower relative deficiency of qi and blood in terms of the qi mecha-nism.In Treatise on Cold Damage Diseases,the formula-syndromes with upper heat and lower cold include:stomach heat and spleen cold,dysfunction in the middle earth,leading to Coptis Decoction syndrome,and Rhizoma Zingiberis and Scutellaria,and Coptis and Ginseng Decoction syndrome,wind-cold stagnation,internal disturbance of ministerial fire,leading to reverting yin disease outline syn-drome and Mume Pill syndrome;Mistreatment and pathogenic stagnation,diaphragmatic heat and spleen cold,leading to Gardenia and Rhizoma Zingiberis Decoction syndrome;Deficient healthy qi and pathogenic stagnation,lung heat and spleen cold,leading to Ephedra and Cimicifuga Decoction syndrome;Cardinal dysfunction,gallbladder heat and spleen cold,leading to Bupleurum and Cinnamon Twig and Dried Ginger Decoction syndrome.The core idea of Zhang Zhongjing's treatment of upper-heat and lower-old syndrome can be roughly divided into three points:Firstly,in terms of the distribution of cold and heat,the upper heat should be cleared,the lower cold should be warmed,the cold and heat should be balanced,and the medication should be bold and precise,with an extremely accurate grasp of the effects of the related medicines.Secondly,emphasis should be placed on smoothly regulating qi.It is crucial to regulate qi based on the physiological functions of various organs and consider the characteristics of the organs themselves.Products that promote or regulate qi circulation should not be used blindly;instead,focus should primarily be on enhancing the physiological functions of the or-gans themselves.Thirdly,based on patients'pulse condition and symptoms,it is necessary to analyze their underlying causes and patho-genesis."Treatment must be based on the root cause,"requiring identification of the main pathogenic factors affecting patients.Subse-quently,from an overall perspective on yin and yang directionality,adjustments should aim for a physiological state characterized by yin-yang balance.关键词
上热下寒证/清上温下/寒热兼施/经方/《伤寒论》/张仲景Key words
upper-heat and lower-cold syndrome/clearing the upper and warming the lower/using both cold and warm therapies simulta-neously/classical formulas/Treatise on Cold Damage Diseases/Zhang Zhongjing分类
医药卫生引用本文复制引用
张欣怡,张艳艳,宋媛媛,考希良..《伤寒论》上热下寒证浅析[J].河南中医,2024,44(7):983-988,6.基金项目
第七批全国老中医药专家学术经验继承工作项目{国中医药人教函[2022]76号} （）
