中医临床研究2025，Vol.17Issue(18)：91-95,5.DOI:10.3969/j.issn.1674-7860.2025.18.013
基于六经辨证联合脏腑理论阐述栀子类方应用的动态病位变化特征
The dynamic characteristics of disease location changes of Zhizi-based prescriptions in the clinical application based on the theory of six-meridian differentiation plus Zang-fu organs
摘要
Abstract
The Zhizichi decoction(栀子豉汤)is an important representative of the small,quick-acting,and flexible type of prescription in Shanghan Lun(《伤寒论》).Its six meridian affiliation was not clearly defined in this book,but it was described in chapers of Taiyang(太阳)meridian disease,Yangming(阳明)meridian disease,Jueyin(厥阴)meridian disease,etc.It can be seen that this prescription is a non-fixed supplementary,that can be formulated independently or added or reduced,and is an important representative prescription of the dynamic changes of six-meridian syndrome differentiation.In this study,based on clinical application experience and the record in related works,a brand-new analysis of Zhizi(Fructus Gardeniae)-based prescriptions is conducted from aspects of disease syndrome,six-meridian and Zang-fu(脏 腑)organ positions,and the transmission law.It is believed that the six-meridian disease positions of Zhizi-based prescriptions are flexible and changeable,may be between Yangming meridian and Shaoyang(少阳)meridian mainly,which has the characteristics of half-exterior halfinterior,therefore,the involvement range is very wide.It may include pericardium,diaphragm area,gastric epigastric region and its interstitial space.With the changes of the lesion scope,it may also cover important Zang-fu organs such as liver and gallbladder,Sanjiao(三焦)and so on,and its core disease location is pericardium.The pathogenic nature of depressed heat pervades Sanjiao,mainly in upper energizer and middle energizer,which exhausts Qi(气)and body fluids,or involves both dampness and heat.Combined with the characteristics of tongue veins,the disease syndrome and pathogenic nature are studied,which is characterized by"floating tight pulse""coated tongue""slightly yellow coated tongue,and powerful Cun pulse",etc.,also proves that the related syndrome is not a deficiency syndrome,and there should be a acute fever.The essence of this syndrome is that the fluid in spleen and stomach is constantly consumed during the course of the disease,but the damage is not severe,which is stagnated heat.Moreover,it is not prolonged fever or prolonged deficiency,which is characterized by the symptoms of red tongue with little coating or no coating,and has not reached the stage of severe injury to stomach Yin(阴)and failure to produce nutrient substance.Therefore,it is not consistent with the condition of serious deficiency of stomach Yin of the syndromes related to the Shashen Maidong decoction(沙参麦冬汤)and the Yiwei decoction(益胃汤),and clinical attention should be paid to differentiated diagnosis and treatment.The author's team uses Zhizi-based prescriptions flexibly and alternately in the early stage of acute and miscellaneous diseases,in order to treat acute symptoms and prevent pathogenic factors from penetrating deeply.关键词
栀子豉汤/《伤寒论》/六经辨证Key words
The Zhizichi decoction/Shanghan Lun/Six-meridian syndrome differentiation分类
医药卫生引用本文复制引用
孙一凡,袁思成,王醒..基于六经辨证联合脏腑理论阐述栀子类方应用的动态病位变化特征[J].中医临床研究,2025,17(18):91-95,5.基金项目
江苏省中医药管理局科技专项(2020ZX03). （2020ZX03）
