世界中医药2026，Vol.21Issue(12)：2211-2217,2223,8.DOI:10.3969/j.issn.1673-7202.2026.12.008
"胆-肠轴"假说:小柴胡汤证病机理论新探
"Gallbladder-intestine Axis"Hypothesis:A New Exploration of the Pathogenesis Theory of Xiaochaihu Decoction Syndromes
摘要
Abstract
This study systematically reviews the relevant passages on Xiaochaihu Decoction syndromes in the Treatise on Febrile Diseases and proposes a new interpretation of the traditional pathogenesis of Xiaochaihu Decoction syndromes by integrating the ac-ademic debates among physicians of past dynasties and recent research advances.Through textual analysis combined with modern anatomical knowledge and logical deduction,the study finds that the essence of core symptoms such as"chest and hypochondriac fullness and discomfort"and"alternating chills and fever"is intestinal qi stagnation caused by dysfunction of the gallbladder's dredging and discharging function,rather than merely a vague spatial concept of simultaneous exterior and interior disease.The syn-drome differentiation logic of"diagnosis based on the presence of one key symptom"should follow a ternary model of"core patho-genesis-main symptom group-dynamic syndrome differentiation",the essence of which is to identify the key nodes of dysfunction of the gallbladder-intestine pivot.The disputes among physicians of past dynasties over"half-exterior and half-interior"stem from confusion between the state of pathogenesis and anatomical location,whereas the primary disease location of Xiaochaihu Decoction syndromes is actually"under the hypochondrium",and its dynamic evolution conforms to the pathological characteristics of dys-functional coordination of the"gallbladder-intestine axis".By reinterpreting the classical passages in combination with modern a-natomy,this study reveals the pathogenesis chain of"gallbladder stagnation-intestinal obstruction"in Xiaochaihu Decoction syn-dromes,providing a basis for the clinical application and theoretical innovation of classical prescriptions.关键词
小柴胡汤证/少阳证/核心病机/半表半里/胸胁苦满/解剖学Key words
Xiaochaihu Decoction syndromes/Shaoyang syndrome/Core pathogenesis/Half-exterior and half-interior/Chest and hypochondriac fullness and discomfort/Anatomy分类
医药卫生引用本文复制引用
刘磊,刘清泉,莫之准,刘禹翔,林基勇,桑凯,钟培玲,谢伟昌,姜小艳,黄彬.."胆-肠轴"假说:小柴胡汤证病机理论新探[J].世界中医药,2026,21(12):2211-2217,2223,8.基金项目
国家自然科学基金青年科学基金项目(82204983) （82204983）
黄彬广东省名中医传承工作室建设项目[粤中医办函(2020)1号] （2020）
深圳市"医疗卫生三名工程"项目(SZZYSM202411012). （SZZYSM202411012）
