北京中医药大学学报2025，Vol.48Issue(2)：161-165,5.DOI:10.3969/j.issn.1006-2157.2025.02.003
浅析《金匮要略》"历节黄汗"
Brief analysis on"Lijie and yellowish sweating"in Synopsis of Golden Chamber
摘要
Abstract
"Lijie and yellowish sweating"originates from the chapter on stroke and arthralgia diseases in Synopsis of Golden Chamber.Later generations typically interpret it as yellow fluid oozing from painful joints,a characteristic manifestation of arthralgia.In Western medicine,Lijie corresponds to diseases such as gouty arthritis,with its primary clinical manifestations being redness,swelling,heat,and painful joints,most often without yellow fluid discharge.Therefore,the interpretation of"Lijie and yellowish sweating"contradicts the clinical manifestations often observed in this disease.Thus,this article reinterprets the meaning of"Lijie and yellowish sweating"from the pathogenesis of"sweat exposure to water,as if water harms the heart",combined with the viewpoints of other medical practitioners.Determining the meaning of"yellowish sweating"is crucial for understanding the pathogenesis of arthralgia and clarifying the relationship between arthralgia and yellowish sweating.ZHANG Zhongjing mentioned arthralgia and"yellowish sweating"together,not to differentiate between the two diseases but to emphasize the common pathogenesis of the two,namely,the cold and dampness injuring the heart,blood,and vessels.This paper proposes a new explanation of"Lijie and yellowish sweating",which suggests that"yellowish sweating"is not confined to the joints but can be found all over the body.The pathogenesis of"Lijie and yellowish sweating"lies in the insufficiency of the liver and kidney and exogenous water dampness,leading to disharmony between nutrient qi and defensive qi and between yin and yang.Primary treatment should harmonize yingfen and weifen,as well as tonify and replenish the liver and kidney.The clinical selection of medicines can be considered Guizhi Decotion,a type of formula.The pathogenesis of"Lijie and yellowish sweating"is complex,and clinical treatment should be comprehensively considered to achieve the best therapeutic effect.关键词
金匮要略/历节黄汗/如水伤心/病机Key words
Synopsis of Golden Chamber/Lijie and yellowish sweating/as if water harms the heart/pathogenesis分类
医药卫生引用本文复制引用
兰芯,任梓林,邵奇,郑雨晓,李长香,程发峰,王雪茜,王庆国..浅析《金匮要略》"历节黄汗"[J].北京中医药大学学报,2025,48(2):161-165,5.基金项目
国家自然科学基金项目(No.82104560,No.U21A20400) National Natural Science Foundation of China(Nos.82104560 and U21A20400) （No.82104560,No.U21A20400）
