浙江中医药大学学报2025，Vol.49Issue(10)：1255-1262,8.DOI:10.16466/j.issn1005-5509.2025.10.006
从五运六气解读《伤寒论》之合病并病
Interpret the Combined Diseases and Complicated Diseases in Shanghan Lun From The Five Movements and Six Qi
摘要
Abstract
[Objective]Based on the theory of five movements and six Qi,to construct the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun(Treatise on Febrile Diseases)and clarify the disease location category,transmission rule and syndrome characteristics.[Methods]Based on the temporal basis of the explanation system of the six meridians and diseases in Shanghan Lun,combined with TIAN Helu's academic thought of"three parts and six meridians",through the pathogenesis diagram and literature mutual reference,the theory of seven categories of combined diseases and complicated diseases Qi was analyzed hierarchically.the systematic classification framework of combined diseases and complicated diseases in Shanghan Lun was constructed,and the disease location category,transmission law and syndrome characteristics were expounded.[Results]The complex diseases described in Shanghan Lun can be classified into seven major categories:Taiyang-Yangming complex disease,Taiyang-Shaoyang complex disease,Yangming-Shaoyang complex disease,triple Yang complex disease,Taiyang-Taiyin complex disease,Taiyang-Shaoyin complex disease and Taiyang-Jueyin complex disease.The first four categories pertain to disorders within the exterior system,while the latter three involve conditions that progress from exterior to interior patterns.The Taiyang-Yangming syndrome can be further divided into three types:cold pathogenic disease(treated with Mahuang Decoction),warm disease(managed with Gegen Decoction),and complex diseases(addressed with Guizhi Decoction for mild exterior Yang deficiency and Dachengqi Decoction for solid interior syndromes).For Taiyang-Shaoyang combined disease,warm disease is treated with Huangqin Decoction to clear heat and nourish Yin,while wind-cold comorbidity is managed through acupuncture at points such as Dazhui(GV14)and Feishu(BL13).Yangming-Shaoyang combined disease involves the use of Xiaochengqi Decoction for mild purgation to resolve interior heat.Triple Yang combined disease is treated with Baihu Decoction to clear Qi-level heat,and Jinshui(fluid)injury is addressed with ginseng to support Yin and Qi.In Taiyang-Taiyin complex disease,surface syndromes accompanied with internal deficiency are treated with Guizhi Renshen Decoction,internal Yin deficiency with Guizhi plus Shaoyao Decoction,and interior excess with Guizhi plus Huangqin Decoction.Renshen For Taiyang-Shaoyin combined disease,cold pathogenic disease is managed with Mahuang Fuzi Xixing Decoction to warm Yang,while warm disease is treated with Huanglian Ejiao Decoction to clear heat and nourish Yin.Lastly,Taiyang-Jueyin complex disease presents with mixed patterns of cold-heat and deficiency-excess,and is treated with Mahuang Shengma Decoction to resolve both exterior and interior symptoms.[Conclusion]The system of TIAN's"three parts and six meridians"integrates the theory of the six meridians to explain the seasons and the five movements and six Qi,and reveals that the nature of diseases and diseases combination in Shanghan Lun is a unified model of space-time disease location.It provides a paradigm of"cause,location and method"for clinical differentiation and treatment,and deepens the practical connotation of the theory of"correspondence between nature and human"in traditional Chinese medicine.关键词
《伤寒论》/合病并病/六经病欲解时/三部六经/五运六气/田合禄Key words
Shanghan Lun/complicated diseases/the system of the six meridians when the disease is to be solved/three parts and six meridians/five movements and six Qi/TIAN Helu分类
医药卫生引用本文复制引用
李正富,田合禄..从五运六气解读《伤寒论》之合病并病[J].浙江中医药大学学报,2025,49(10):1255-1262,8.基金项目
浙江省中青年临床名中医培养项目(浙中医药[2022]7 号) Zhejiang Province Young and Middle-Aged Clinical Famous TCM Doctors Training Project(Z.TCM.[2022]7) （浙中医药[2022]7 号）
