本證是外(wai)感熱病后期(qi)陰陽勝(sheng)復所致的病證。
主要臨床表現(xian):手(shou)(shou)足(zu)厥(jue)(jue)冷與發(fa)熱(re)交(jiao)替出現(xian),既可以(yi)先出現(xian)手(shou)(shou)足(zu)厥(jue)(jue)冷,然后再出現(xian)發(fa)熱(re),也可以(yi)先見發(fa)熱(re),然后再見手(shou)(shou)足(zu)厥(jue)(jue)冷,同時伴有煩躁、脈沉等癥狀。
病機分析(xi):本證以(yi)陰陽勝復邪(xie)(xie)正(zheng)斗爭為(wei)特征(zheng)。陽氣虛陰邪(xie)(xie)盛則(ze)手(shou)(shou)足厥冷(leng),陽氣恢復抗(kang)邪(xie)(xie)則(ze)發熱,手(shou)(shou)足厥冷(leng)與(yu)發熱交(jiao)替出現反映了(le)邪(xie)(xie)正(zheng)斗爭的形勢。若先手(shou)(shou)足厥冷(leng)后發熱,為(wei)邪(xie)(xie)退正(zheng)勝,預后好;若先發熱后手(shou)(shou)足逆冷(leng),為(wei)邪(xie)(xie)盛正(zheng)虛,預后差。
相(xiang)似證(zheng)(zheng)候的辨別:本證(zheng)(zheng)當與單純的寒(han)厥(jue)證(zheng)(zheng)相(xiang)辨別。寒(han)厥(jue)證(zheng)(zheng)為陽虛陰(yin)盛,表(biao)(biao)現(xian)(xian)為一派陰(yin)寒(han)之象,一般(ban)無熱性癥狀。本證(zheng)(zheng)為厥(jue)熱交(jiao)替出現(xian)(xian),有發(fa)熱等臨床表(biao)(biao)現(xian)(xian)。
辨證注意點(dian):抓住手足厥(jue)冷與發熱交替出現的特征。
目錄(lu)1拼(pin)音(yin)2英文參考(kao)3概述4十(shi)二皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)或六經(jing)(jing)(jing)(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)的(de)簡稱·皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu) 4.1皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)的(de)概念4.2六經(jing)(jing)(jing)(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)與(yu)診(zhen)治(zhi)4.3六經(jing)(jing)(jing)(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)與(yu)辨證(zheng)4.4六經(jing)(jing)(jing)(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)示意圖 4.4.1太(tai)陽(yang)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“關樞”4.4.2陽(yang)明(ming)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“害蜚”4.4.3少陽(yang)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“樞持(chi)”4.4.4太(tai)陰(yin)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“關蟄(zhe)”4.4.5少陰(yin)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“樞儒”4.4.6厥陰(yin)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)“害肩”4.4.7六經(jing)(jing)(jing)(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)與(yu)關、闔、樞表5經(jing)(jing)(jing)(jing)穴別名(ming)·皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu) 5.1承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴的(de)別名(ming)5.2出處5.3穴名(ming)解(jie)5.4所屬部(bu)(bu)(bu)(bu)位5.5承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴的(de)定(ding)位5.6承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴的(de)取法5.7承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴穴位解(jie)剖(pou) 5.7.1層次解(jie)剖(pou)5.7.2穴區(qu)神(shen)經(jing)(jing)(jing)(jing)、血(xue)管 5.8承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴的(de)功效與(yu)作用5.9承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴主(zhu)治(zhi)病證(zheng)5.10刺灸法 5.10.1刺法5.10.2灸法 5.11承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴的(de)配(pei)伍5.12文獻(xian)摘要5.13承(cheng)(cheng)(cheng)扶(fu)(fu)(fu)穴研究進展 6參考(kao)資料附:1古(gu)籍中的(de)皮(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu) 1拼(pin)音(yin) pí bù
2英文(wen)參考 skin areas [湘雅醫學專業詞典(dian)]
Chéngfú BL36(經穴別(bie)名) [中國針灸學(xue)詞典]
dermal parts [中(zhong)醫藥學名詞審定委員(yuan)會.中(zhong)醫藥學名詞(2004)]
3概(gai)述 皮部(bu):1.十二皮部(bu)或六經(jing)皮部(bu)的簡稱(cheng);2.經(jing)穴(xue)別名。
4十二皮部或六經皮部的簡稱·皮部 皮部指人體表皮按十二經脈分布劃分為十二個部區,故稱皮部[1]。《黃帝內(nei)經(jing)素問·皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)論(lun)》:“欲知皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu),……以經(jing)脈為(wei)(wei)紀者(zhe),諸經(jing)皆然。”十二皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)按手(shou)足(zu)(zu)同名(ming)(ming)經(jing)相合,則稱(cheng)(cheng)(cheng)六(liu)經(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)[1]。皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)是(shi)指十二經(jing)脈及其所屬絡脈在(zai)(zai)體表(biao)的(de)分(fen)(fen)區,為(wei)(wei)經(jing)氣(qi)布散之所在(zai)(zai),具(ju)有(you)保衛(wei)機體,抗(kang)御外(wai)邪的(de)功能,并能反映十二經(jing)脈的(de)病證[2]。皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)是(shi)十二皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)或六(liu)經(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)的(de)簡稱(cheng)(cheng)(cheng)[3]。全身(shen)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)膚按經(jing)脈分(fen)(fen)部(bu)(bu)(bu)(bu)(bu)(bu)[3]。皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)一(yi)絡一(yi)經(jing)一(yi)腑一(yi)臟,為(wei)(wei)疾病傳變的(de)層(ceng)次,因此從外(wai)部(bu)(bu)(bu)(bu)(bu)(bu)診察和施治(zhi)則可推斷和治(zhi)療內(nei)部(bu)(bu)(bu)(bu)(bu)(bu)的(de)疾患[3]。十二皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)是(shi)根據十二經(jing)脈分(fen)(fen)布得名(ming)(ming),在(zai)(zai)診治(zhi)時手(shou)足(zu)(zu)相通(tong),上(shang)下同法(fa),故(gu)十二皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)合為(wei)(wei)六(liu)經(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu),且各(ge)有(you)專(zhuan)名(ming)(ming)[3]。臨床上(shang)的(de)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)膚針、刺(ci)絡、敷貼等外(wai)治(zhi)法(fa),都是(shi)結(jie)合皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)理(li)論(lun)的(de)實際應用[3]。六(liu)經(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)各(ge)有(you)專(zhuan)名(ming)(ming):太陽(yang)(yang)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)關(guan)樞,陽(yang)(yang)明皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)害(hai)蜚,少陽(yang)(yang)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)樞持,太陰皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)關(guan)蟄(zhe),少陰皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)樞儒(ru),厥陰皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)稱(cheng)(cheng)(cheng)害(hai)肩[1]。六(liu)經(jing)皮(pi)(pi)(pi)(pi)(pi)(pi)(pi)部(bu)(bu)(bu)(bu)(bu)(bu)名(ming)(ming)稱(cheng)(cheng)(cheng)見(jian)下表(biao)。
六(liu)經皮部(bu)名稱表(biao)(表(biao)格出自(zi)《中國(guo)針灸學詞典》)
六經名
太陽
陽明
少陽
太陰
少陰
厥陰
皮部名
關樞
害蜚
樞持
關蟄
樞儒
害肩
《黃帝(di)內經(jing)素(su)問(wen)·皮(pi)(pi)(pi)部(bu)(bu)論(lun)》:“欲知皮(pi)(pi)(pi)部(bu)(bu)……以經(jing)脈(mo)為紀者,諸經(jing)皆然。”按手足同(tong)名(ming)經(jing)相(xiang)合,則(ze)稱(cheng)六(liu)經(jing)皮(pi)(pi)(pi)部(bu)(bu)。六(liu)經(jing)皮(pi)(pi)(pi)部(bu)(bu)各有專名(ming):太陽皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)關樞(shu),陽明皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)害(hai)蜚,少(shao)陽皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)樞(shu)持,太陰皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)關蟄,少(shao)陰皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)樞(shu)儒(ru),厥陰皮(pi)(pi)(pi)部(bu)(bu)稱(cheng)害(hai)肩(jian)。詳各該條。
《黃帝內經(jing)素問·皮部(bu)論(lun)》說(shuo)(shuo):“欲知皮部(bu),以經(jing)脈(mo)為(wei)紀者,諸經(jing)皆(jie)然”。又說(shuo)(shuo):“凡十二經(jing)絡(luo)脈(mo)者,皮之部(bu)也”。
經脈呈(cheng)線(xian)狀分(fen)布(bu),絡脈呈(cheng)網狀分(fen)布(bu),皮(pi)部是面的劃分(fen)。
十二皮部,手足(zu)上下相合稱為(wei)六經皮部。
體內的(de)疾病(bing),通(tong)過經絡可反映到皮(pi)(pi)部(bu)(bu);外(wai)部(bu)(bu)的(de)病(bing)邪(xie)或(huo)治(zhi)療方法(fa),則可從皮(pi)(pi)部(bu)(bu)影響(xiang)經絡及臟腑,因而外(wai)部(bu)(bu)診察法(fa)(外(wai)診法(fa))和外(wai)部(bu)(bu)治(zhi)療法(fa)(外(wai)治(zhi)法(fa))與皮(pi)(pi)部(bu)(bu)關系最(zui)大。
皮(pi)(pi)(pi)部診(zhen)(zhen)察法(fa):又稱診(zhen)(zhen)絡法(fa),主要(yao)是審察皮(pi)(pi)(pi)膚(fu)和(he)絡脈的(de)(de)(de)顏色(se)(se)變化(hua),屬中(zhong)醫(yi)學(xue)色(se)(se)診(zhen)(zhen)的(de)(de)(de)一(yi)(yi)項內容。《黃帝內經素問·皮(pi)(pi)(pi)部論(lun)》說:“其色(se)(se)多青則痛,多黑則痹,黃赤(chi)則熱,多白則寒。”近代在皮(pi)(pi)(pi)部色(se)(se)診(zhen)(zhen)的(de)(de)(de)基礎上,又有觀(guan)察皮(pi)(pi)(pi)膚(fu)上的(de)(de)(de)丘疹(主要(yao)在背部),檢(jian)查皮(pi)(pi)(pi)下的(de)(de)(de)硬結反(fan)應,皮(pi)(pi)(pi)膚(fu)的(de)(de)(de)感覺(jue)差異和(he)導電量變化(hua)等,作(zuo)為診(zhen)(zhen)斷的(de)(de)(de)一(yi)(yi)種方法(fa),這是皮(pi)(pi)(pi)部外診(zhen)(zhen)法(fa)的(de)(de)(de)發展(zhan)。
皮(pi)(pi)部治療法(fa)(fa):包括各(ge)種淺刺(ci)(ci)(ci)(ci)法(fa)(fa)以(yi)及非針(zhen)(zhen)刺(ci)(ci)(ci)(ci)的(de)(de)(de)多種外治法(fa)(fa)。《黃帝內(nei)經靈樞·官針(zhen)(zhen)》以(yi)刺(ci)(ci)(ci)(ci)皮(pi)(pi)為主的(de)(de)(de)刺(ci)(ci)(ci)(ci)法(fa)(fa)就有(you)半刺(ci)(ci)(ci)(ci)和毛刺(ci)(ci)(ci)(ci)等(deng),近(jin)代應(ying)用的(de)(de)(de)皮(pi)(pi)膚(fu)針(zhen)(zhen)是(shi)它的(de)(de)(de)發展。皮(pi)(pi)膚(fu)針(zhen)(zhen)的(de)(de)(de)叩刺(ci)(ci)(ci)(ci)和腕(wan)踝針(zhen)(zhen)的(de)(de)(de)沿皮(pi)(pi)刺(ci)(ci)(ci)(ci),都結合皮(pi)(pi)部的(de)(de)(de)分(fen)區應(ying)用。再(zai)如皮(pi)(pi)內(nei)針(zhen)(zhen)法(fa)(fa)、挑刺(ci)(ci)(ci)(ci)法(fa)(fa)、敷(fu)貼(tie)法(fa)(fa)、溫灸法(fa)(fa)以(yi)及刺(ci)(ci)(ci)(ci)絡(luo)撥罐(guan)等(deng)法(fa)(fa)的(de)(de)(de)應(ying)用,都是(shi)基(ji)于同一原理。皮(pi)(pi)部的(de)(de)(de)分(fen)區為刺(ci)(ci)(ci)(ci)灸法(fa)(fa)的(de)(de)(de)應(ying)用擴(kuo)大了范圍。
六經皮部的命名包含(han)有(you)氣機變化的深(shen)意(yi),其中意(yi)義可結合六經病證的特點去(qu)理解(jie),從陰陽、表里(li)、寒熱、虛(xu)實的對比關系去(qu)分析。見方有(you)執的《傷寒論(lun)條(tiao)辨》。
柯(ke)韻伯《傷寒論翼(yi)》更(geng)明確提出:“《皮(pi)(pi)部(bu)論》云,皮(pi)(pi)有分(fen)部(bu)……,此(ci)仲(zhong)景(jing)創立六(liu)經部(bu)位之(zhi)原”,并說:“仲(zhong)景(jing)之(zhi)六(liu)經是分(fen)六(liu)區,地面所該者廣(guang)。雖以(yi)脈為(wei)經絡(luo),而不專(zhuan)在(zai)經絡(luo)上立說。凡風寒濕熱(re)、內(nei)傷外感,自表及里,有寒有熱(re),或虛(xu)或實,無乎不包”。意指以(yi)六(liu)經皮(pi)(pi)部(bu)來概括表里、寒熱(re)、虛(xu)實各證,作為(wei)辨證施治的綱領(ling)。
皮(pi)部(背(bei)面)(圖出自《中(zhong)國針灸學(xue)詞典》)
皮部(正(zheng)面)(圖(tu)出(chu)自《中(zhong)國針灸學詞典》)
4.4.1太(tai)(tai)陽(yang)(yang)(yang)皮(pi)部“關樞” 關樞為(wei)太(tai)(tai)陽(yang)(yang)(yang)經陽(yang)(yang)(yang)絡之(zhi)(zhi)(zhi)稱[4]。《黃帝內(nei)經素問·皮(pi)部論》:“太(tai)(tai)陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)陽(yang)(yang)(yang),名(ming)曰(yue)(yue)關樞,上下同法(fa),視其(qi)部中(zhong)有浮(fu)絡者,皆(jie)太(tai)(tai)陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)絡也。”張景岳注:“關,衛固(gu)也。少陽(yang)(yang)(yang)為(wei)三陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)樞,展布陽(yang)(yang)(yang)氣于(yu)(yu)中(zhong),太(tai)(tai)陽(yang)(yang)(yang)則衛固(gu)其(qi)氣而約束于(yu)(yu)外,故曰(yue)(yue)關樞。”
太(tai)(tai)陽(yang)(yang)是三陽(yang)(yang)之(zhi)(zhi)“關”,主一身之(zhi)(zhi)表,統營衛(wei)(wei)(wei)而(er)應皮毛,是衛(wei)(wei)(wei)外屏(ping)障(zhang),為(wei)諸(zhu)經之(zhi)(zhi)藩籬,所(suo)屬皮部稱(cheng)“關樞”。陽(yang)(yang)氣(qi)衛(wei)(wei)(wei)外而(er)為(wei)固,外邪(xie)侵犯人(ren)體,太(tai)(tai)陽(yang)(yang)經首先受病。《黃帝內(nei)經靈樞·百病始生》說:“是故(gu)虛邪(xie)之(zhi)(zhi)中人(ren)也,始于(yu)皮膚(fu),皮膚(fu)緩則(ze)(ze)腠理(li)開,開則(ze)(ze)邪(xie)從毛發入(ru)……”外邪(xie)束表,正(zheng)氣(qi)向外抗邪(xie),于(yu)是出(chu)(chu)現(xian)惡寒(han)發熱,故(gu)脈(mo)(mo)應之(zhi)(zhi)為(wei)浮(fu)(fu)。足太(tai)(tai)陽(yang)(yang)經脈(mo)(mo)從頭(tou)走足,行于(yu)人(ren)體的背(bei)部,衛(wei)(wei)(wei)氣(qi)郁阻(zu),經絡之(zhi)(zhi)氣(qi)不(bu)暢,則(ze)(ze)頭(tou)項強痛(tong);外邪(xie)初襲,衛(wei)(wei)(wei)陽(yang)(yang)被遏(e),則(ze)(ze)見惡寒(han);正(zheng)氣(qi)抗邪(xie),邪(xie)正(zheng)交(jiao)爭,則(ze)(ze)出(chu)(chu)現(xian)發熱。這些(xie)癥狀(zhuang)都是太(tai)(tai)陽(yang)(yang)病的病理(li)反映,因(yin)病位在表,故(gu)稱(cheng)為(wei)表證。由(you)于(yu)感邪(xie)的不(bu)同和體質的差異,所(suo)以(yi)同是太(tai)(tai)陽(yang)(yang)病,又有惡風、發熱、自汗(han)(han)出(chu)(chu)、脈(mo)(mo)浮(fu)(fu)緩,以(yi)及惡寒(han)、發熱、頭(tou)身疼(teng)痛(tong)、無(wu)汗(han)(han)而(er)喘、脈(mo)(mo)浮(fu)(fu)緊等不(bu)同證候。因(yin)腠理(li)皮毛之(zhi)(zhi)關樞失調,邪(xie)氣(qi)因(yin)入(ru),故(gu)善(shan)治者治皮毛,治療當(dang)以(yi)解(jie)表。
4.4.2陽(yang)明(ming)(ming)(ming)皮部(bu)“害(hai)蜚(fei)(fei)” 害(hai)蜚(fei)(fei)為六經皮部(bu)之(zhi)(zhi)(zhi)一,陽(yang)明(ming)(ming)(ming)皮部(bu)名[5]。“害(hai)”古與盍、闔(he)通用,應讀作“闔(he)”,“蜚(fei)(fei)”是陽(yang)氣飛動之(zhi)(zhi)(zhi)意[5]。陽(yang)經以陽(yang)明(ming)(ming)(ming)為闔(he),故稱“害(hai)蜚(fei)(fei)”[5]。《黃帝內經素(su)問·皮部(bu)論》:“陽(yang)明(ming)(ming)(ming)之(zhi)(zhi)(zhi)陽(yang),名曰害(hai)蜚(fei)(fei),上(shang)下(xia)同法,視(shi)其部(bu)中有(you)浮絡者,皆陽(yang)明(ming)(ming)(ming)之(zhi)(zhi)(zhi)絡也。”說明(ming)(ming)(ming)手足陽(yang)明(ming)(ming)(ming)經循行部(bu)位上(shang)所見到(dao)的浮絡都屬于陽(yang)明(ming)(ming)(ming)絡,而浮絡之(zhi)(zhi)(zhi)外的皮膚(fu),即(ji)為陽(yang)明(ming)(ming)(ming)之(zhi)(zhi)(zhi)皮部(bu)[5]。
陽明(ming)(ming)(ming)為(wei)(wei)(wei)陽氣(qi)(qi)亢盛(sheng),是三陽之(zhi)“闔(he)”。多(duo)氣(qi)(qi)多(duo)血,氣(qi)(qi)血旺盛(sheng),為(wei)(wei)(wei)五臟六腑之(zhi)海。所(suo)屬皮部稱“害蜚”,蜚即陽氣(qi)(qi)飛揚(yang)的意(yi)思。外(wai)感病(bing)過程中,陽明(ming)(ming)(ming)病(bing)是陽氣(qi)(qi)偏亢,邪熱最(zui)盛(sheng)的階段。邪熱入里,癥(zheng)見身熱、汗(han)(han)自出、不(bu)(bu)惡寒、反惡熱等,為(wei)(wei)(wei)陽明(ming)(ming)(ming)熱證(zheng)。邪熱亢盛(sheng),內傳與腸(chang)中糟粕相搏,燥熱實(shi)(shi)積結聚腸(chang)腑為(wei)(wei)(wei)陽明(ming)(ming)(ming)腑證(zheng)。《傷寒論》說(shuo):“陽明(ming)(ming)(ming)之(zhi)為(wei)(wei)(wei)病(bing),胃(wei)家(jia)實(shi)(shi)是也(ye)”。里熱實(shi)(shi)證(zheng)聚合到陽明(ming)(ming)(ming),闔(he)病(bing)的癥(zheng)狀表(biao)現(xian)如柯韻(yun)伯所(suo)說(shuo):“陽明(ming)(ming)(ming)為(wei)(wei)(wei)闔(he),故陽明(ming)(ming)(ming)必以(yi)闔(he)病(bing)為(wei)(wei)(wei)主(zhu),不(bu)(bu)大便(bian)因(yin)闔(he)也(ye),不(bu)(bu)小便(bian)亦闔(he)也(ye),不(bu)(bu)能(neng)食,食難用(yong)飽,初欲(yu)食,反不(bu)(bu)能(neng)食皆(jie)闔(he)也(ye)。自汗(han)(han)盜汗(han)(han)表(biao)開而里闔(he)也(ye),反無汗(han)(han)內外(wai)皆(jie)闔(he)也(ye)”。治療當以(yi)清(qing)下(xia)實(shi)(shi)熱,保存津液為(wei)(wei)(wei)主(zhu)。
4.4.3少陽(yang)皮(pi)(pi)部(bu)(bu)“樞(shu)(shu)(shu)(shu)持” 樞(shu)(shu)(shu)(shu)持為六經(jing)(jing)皮(pi)(pi)部(bu)(bu)之(zhi)(zhi)(zhi)一,屬少陽(yang)的皮(pi)(pi)部(bu)(bu)[6]。《黃帝內經(jing)(jing)素問·皮(pi)(pi)部(bu)(bu)論》:“少陽(yang)之(zhi)(zhi)(zhi)陽(yang),名(ming)曰(yue)(yue)樞(shu)(shu)(shu)(shu)持,上(shang)下(xia)同法,視(shi)其(qi)部(bu)(bu)中有浮(fu)絡(luo)者(zhe),皆(jie)少陽(yang)之(zhi)(zhi)(zhi)絡(luo)也。”說明手足少陽(yang)經(jing)(jing)循行(xing)部(bu)(bu)位上(shang)所見(jian)的浮(fu)絡(luo)都屬于少陽(yang)絡(luo),而浮(fu)絡(luo)之(zhi)(zhi)(zhi)外的皮(pi)(pi)膚,即(ji)為少陽(yang)之(zhi)(zhi)(zhi)皮(pi)(pi)部(bu)(bu)[6]。張景岳注:“樞(shu)(shu)(shu)(shu),樞(shu)(shu)(shu)(shu)機(ji)也;,持,主持也。少陽(yang)居(ju)三陽(yang)表里之(zhi)(zhi)(zhi)間,如樞(shu)(shu)(shu)(shu)之(zhi)(zhi)(zhi)運,而持其(qi)出入之(zhi)(zhi)(zhi)機(ji),故曰(yue)(yue)樞(shu)(shu)(shu)(shu)持。”
少陽(yang)是(shi)三(san)陽(yang)之“樞”,外鄰太陽(yang),內接陽(yang)明(ming),介(jie)于太陽(yang)陽(yang)明(ming)之間,職司升降和(he)(he)運轉(zhuan),可出(chu)可入(ru)如樞機(ji),所屬(shu)皮部(bu)稱“樞持(chi)”。少陽(yang)病大(da)多見(jian)于太陽(yang)轉(zhuan)陽(yang)明(ming)的過渡(du)階段,其病變屬(shu)半(ban)表半(ban)里證,病機(ji)為樞機(ji)不(bu)(bu)利,表現為“寒熱往來,胸脅(xie)苦滿(man),嘿嘿不(bu)(bu)欲飲食,心煩喜嘔”等癥(zheng),治宜和(he)(he)解樞機(ji)。
4.4.4太陰(yin)(yin)皮部“關(guan)蟄” 關(guan)蟄為(wei)太陰(yin)(yin)經(jing)陰(yin)(yin)絡(luo)之(zhi)稱[4]。《黃帝內(nei)經(jing)素問·皮部論(lun)》:“太陰(yin)(yin)之(zhi)陰(yin)(yin),名(ming)曰關(guan)蟄,上(shang)下同法,視其部中有(you)浮絡(luo)者(zhe),皆太陰(yin)(yin)之(zhi)絡(luo)也。”張景岳注:“關(guan)者(zhe),固(gu)于外;蟄者(zhe),伏于中。陰(yin)(yin)主藏而太陰(yin)(yin)衛之(zhi),故曰關(guan)蟄。”
太(tai)陰(yin)(yin)(yin)是(shi)三陰(yin)(yin)(yin)之“關(guan)”,亦為病(bing)邪出(chu)入門戶(hu),寒(han)邪直中(zhong),太(tai)陰(yin)(yin)(yin)先傷(shang),病(bing)從口入,直侵太(tai)陰(yin)(yin)(yin)。太(tai)陰(yin)(yin)(yin)脾(pi)(pi)土,喜溫惡濕。邪犯太(tai)陰(yin)(yin)(yin),則(ze)邪多從寒(han)濕而化。其所屬的(de)(de)皮(pi)部(bu)稱“關(guan)蟄(zhe)”,蟄(zhe)即陰(yin)(yin)(yin)盛(sheng)陽伏的(de)(de)意(yi)思(si)。《傷(shang)寒(han)論》說(shuo):“太(tai)陰(yin)(yin)(yin)之為病(bing),腹滿而吐,食不下,自利益甚,時腹自痛”,這(zhe)些都是(shi)太(tai)陰(yin)(yin)(yin)病(bing)里虛(xu)寒(han)證的(de)(de)主要特(te)征,治療以溫中(zhong)祛寒(han),健脾(pi)(pi)燥濕為主。
4.4.5少(shao)陰(yin)(yin)皮部“樞(shu)儒” 樞(shu)儒為六經(jing)皮部之(zhi)一(yi),屬少(shao)陰(yin)(yin)的皮部[6]。《黃帝內經(jing)素問·皮部論》:“少(shao)陰(yin)(yin)之(zhi)陰(yin)(yin),名曰樞(shu)儒,上下同法,視其(qi)部中有浮絡者,皆(jie)少(shao)陰(yin)(yin)之(zhi)絡也。”說(shuo)明手足少(shao)陰(yin)(yin)經(jing)循行部位上所見到的浮絡都屬少(shao)陰(yin)(yin)絡,而浮絡之(zhi)外的皮膚,即為少(shao)陰(yin)(yin)絡[6]。“儒”是柔、順的意思,少(shao)陰(yin)(yin)為三陰(yin)(yin)關(guan)闔之(zhi)樞(shu),其(qi)陰(yin)(yin)氣柔順,故稱樞(shu)儒[6]。
少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)是三陰(yin)(yin)(yin)(yin)(yin)(yin)之(zhi)“樞”,所屬皮部稱“樞儒”,與(yu)少(shao)(shao)(shao)陽相(xiang)對,柯韻伯因解(jie)釋作“陰(yin)(yin)(yin)(yin)(yin)(yin)樞”。少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)包(bao)括手少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)心(xin)、足少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)腎(shen)(shen)。心(xin)屬火(huo),主血脈,又藏(zang)神明,為(wei)一身之(zhi)大主;腎(shen)(shen)屬水,主藏(zang)精,內寄元(yuan)陰(yin)(yin)(yin)(yin)(yin)(yin)元(yuan)陽,為(wei)先(xian)天之(zhi)本。正常情況下,水火(huo)既濟(ji),心(xin)腎(shen)(shen)相(xiang)交,相(xiang)互制約,生(sheng)化(hua)(hua)(hua)不(bu)(bu)息,從(cong)而維(wei)持(chi)人體(ti)正常的(de)(de)(de)生(sheng)命(ming)活(huo)動。少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)為(wei)陰(yin)(yin)(yin)(yin)(yin)(yin)樞,病(bing)(bing)在(zai)少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin),由于致(zhi)病(bing)(bing)因素和體(ti)質的(de)(de)(de)不(bu)(bu)同(tong),其(qi)病(bing)(bing)變不(bu)(bu)但有(you)從(cong)陰(yin)(yin)(yin)(yin)(yin)(yin)化(hua)(hua)(hua)寒(han)(han)的(de)(de)(de)寒(han)(han)化(hua)(hua)(hua)證,如《傷寒(han)(han)論》說:“少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)之(zhi)為(wei)病(bing)(bing),脈微細,但欲寐也”;還有(you)從(cong)陽化(hua)(hua)(hua)熱(re)的(de)(de)(de)熱(re)化(hua)(hua)(hua)證,病(bing)(bing)機主要是陰(yin)(yin)(yin)(yin)(yin)(yin)虛(xu)陽亢,腎(shen)(shen)陰(yin)(yin)(yin)(yin)(yin)(yin)虛(xu)于下,心(xin)火(huo)亢于上,心(xin)神不(bu)(bu)寧,故(gu)見心(xin)煩不(bu)(bu)得臥,以及(ji)口燥咽(yan)干(gan),舌紅(hong)少(shao)(shao)(shao)苔,脈細數等邪熱(re)傷陰(yin)(yin)(yin)(yin)(yin)(yin)的(de)(de)(de)證候(hou)。少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)寒(han)(han)化(hua)(hua)(hua)證治宜溫經回陽,少(shao)(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)熱(re)化(hua)(hua)(hua)證宜育陰(yin)(yin)(yin)(yin)(yin)(yin)清熱(re)。
4.4.6厥陰(yin)(yin)皮部(bu)(bu)(bu)“害(hai)肩” 害(hai)肩為(wei)六經(jing)皮部(bu)(bu)(bu)之(zhi)(zhi)一(yi)[5]。害(hai),古與盍、闔(he)通,闔(he)為(wei)閉合,肩有(you)任(ren)的(de)意思(si)[5]。陰(yin)(yin)經(jing)以厥陰(yin)(yin)為(wei)闔(he),故稱“害(hai)肩”[5]。《黃(huang)帝(di)內經(jing)素問·皮部(bu)(bu)(bu)論》:“心主(zhu)之(zhi)(zhi)陰(yin)(yin),名曰害(hai)肩,上下同法(fa),視其部(bu)(bu)(bu)中有(you)浮(fu)絡(luo)者,皆心主(zhu)之(zhi)(zhi)絡(luo)也(ye)。”說明手足厥陰(yin)(yin)經(jing)循行部(bu)(bu)(bu)位上所見(jian)到的(de)浮(fu)絡(luo)都屬厥陰(yin)(yin)絡(luo),而浮(fu)絡(luo)之(zhi)(zhi)外的(de)皮膚,即為(wei)厥陰(yin)(yin)皮部(bu)(bu)(bu)[5]。
厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin)是(shi)三陰(yin)(yin)(yin)(yin)(yin)之“闔”,兩陰(yin)(yin)(yin)(yin)(yin)交(jiao)盡(jin)謂之厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin),即(ji)太陰(yin)(yin)(yin)(yin)(yin)少陰(yin)(yin)(yin)(yin)(yin)病(bing)(bing)發展到盡(jin)頭即(ji)成厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin)病(bing)(bing),是(shi)六經(jing)病(bing)(bing)證(zheng)傳(chuan)變的(de)(de)最后階段。其所(suo)屬的(de)(de)皮部稱(cheng)“害肩”,肩是(shi)經(jing)受的(de)(de)意思。根據陰(yin)(yin)(yin)(yin)(yin)陽(yang)(yang)(yang)消長的(de)(de)規律(lv),陰(yin)(yin)(yin)(yin)(yin)盡(jin)則陽(yang)(yang)(yang)生,故病(bing)(bing)情演變多(duo)趨極端。厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin)病(bing)(bing)證(zheng)候以寒(han)熱(re)錯(cuo)(cuo)(cuo)雜證(zheng)為多(duo)。《傷寒(han)論》說:“厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin)之為病(bing)(bing),消渴,氣上撞心(xin),心(xin)中疼熱(re),饑而(er)不欲食(shi)(shi),食(shi)(shi)則吐蚘,下(xia)之利不止(zhi)”。病(bing)(bing)邪深入(ru)厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin),肝木乘土,陰(yin)(yin)(yin)(yin)(yin)陽(yang)(yang)(yang)錯(cuo)(cuo)(cuo)亂(luan),失卻(que)正常的(de)(de)調節功能,或為上熱(re)下(xia)寒(han)的(de)(de)寒(han)熱(re)錯(cuo)(cuo)(cuo)雜證(zheng)。但病(bing)(bing)至厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin),邪正交(jiao)爭,陰(yin)(yin)(yin)(yin)(yin)極陽(yang)(yang)(yang)復(fu),正邪互勝(sheng),則可見(jian)厥(jue)(jue)(jue)熱(re)交(jiao)替的(de)(de)厥(jue)(jue)(jue)熱(re)勝(sheng)復(fu)證(zheng),又稱(cheng)陰(yin)(yin)(yin)(yin)(yin)陽(yang)(yang)(yang)勝(sheng)復(fu)證(zheng)。這是(shi)厥(jue)(jue)(jue)陰(yin)(yin)(yin)(yin)(yin)病(bing)(bing)病(bing)(bing)機的(de)(de)又一特(te)點。臨床上往(wang)往(wang)厥(jue)(jue)(jue)熱(re)交(jiao)替,陰(yin)(yin)(yin)(yin)(yin)邪勝(sheng)則厥(jue)(jue)(jue)冷,陽(yang)(yang)(yang)氣復(fu)則發熱(re)。上熱(re)下(xia)寒(han)證(zheng),治(zhi)以清上溫(wen)下(xia)。寒(han)厥(jue)(jue)(jue)治(zhi)療(liao)宜(yi)溫(wen),宜(yi)補;熱(re)厥(jue)(jue)(jue)治(zhi)療(liao)宜(yi)清,宜(yi)下(xia)。
4.4.7六(liu)經(jing)皮部(bu)(bu)與(yu)關、闔、樞表5經(jing)穴別名·皮部(bu)(bu) 皮部(bu)(bu)為經(jing)穴別名[1][3]。出《針灸甲乙經(jing)》。即承扶穴[3][1]。
穴位 承扶 漢語拼音 Chengfu 羅馬拼音 Chengfu 美國英譯名 Support 各
國
代
號 中國 BL36 日本 36 法
國 莫蘭特氏 V50 富耶(ye)氏 德國 B50 英(ying)國 B50 美國 BI36
承(cheng)(cheng)(cheng)(cheng)扶(fu)(fu)為經(jing)穴(xue)(xue)名(ming)(Chéngfú BL36)[7]。出《針灸甲乙經(jing)》。承(cheng)(cheng)(cheng)(cheng)扶(fu)(fu)亦作(zuo)扶(fu)(fu)承(cheng)(cheng)(cheng)(cheng)[8]。別名(ming)肉郄(qie)、陰關(guan)、皮部[8]。屬足太陽膀胱經(jing)[7]。承(cheng)(cheng)(cheng)(cheng)即承(cheng)(cheng)(cheng)(cheng)受,扶(fu)(fu)指佐助,本穴(xue)(xue)位于股(gu)骨上段,當肢體分界的(de)臀(tun)(tun)溝中(zhong)點,有(you)佐助下肢承(cheng)(cheng)(cheng)(cheng)受頭身重量(liang)的(de)作(zuo)用(yong)(yong),故名(ming)承(cheng)(cheng)(cheng)(cheng)扶(fu)(fu)[7]。承(cheng)(cheng)(cheng)(cheng)扶(fu)(fu)穴(xue)(xue)主治(zhi)腰(yao)(yao)腿(tui)部疾(ji)(ji)患(huan):如腰(yao)(yao)腿(tui)疼(teng)(teng)(teng)痛,下肢痿痹,痔(zhi)(zhi)瘡出血,小(xiao)便不(bu)利,大便秘結,腰(yao)(yao)骶(di)(di)臀(tun)(tun)股(gu)部疼(teng)(teng)(teng)痛,痔(zhi)(zhi)疾(ji)(ji),腰(yao)(yao)腿(tui)痛,現(xian)代又多(duo)用(yong)(yong)承(cheng)(cheng)(cheng)(cheng)扶(fu)(fu)穴(xue)(xue)治(zhi)療腰(yao)(yao)背神(shen)經(jing)痛,坐(zuo)骨神(shen)經(jing)痛,小(xiao)兒(er)麻(ma)痹后(hou)遺(yi)癥,腰(yao)(yao)部疼(teng)(teng)(teng)痛,骶(di)(di)部疼(teng)(teng)(teng)痛,臀(tun)(tun)部疼(teng)(teng)(teng)痛,股(gu)部疼(teng)(teng)(teng)痛,大便難,下肢麻(ma)痹或癱(tan)瘓,腰(yao)(yao)骶(di)(di)神(shen)經(jing)根炎(yan),下肢癱(tan)瘓,便秘,痔(zhi)(zhi)瘡,尿潴留,臀(tun)(tun)部炎(yan)癥等。
承(cheng),佐助擔當也(ye)。扶(fu)(fu),木名(ming)。扶(fu)(fu)木,扶(fu)(fu)桑也(ye)。人身坐(zuo)立有木之(zhi)象(xiang),穴在(zai)身軀之(zhi)下(xia)方,正(zheng)為人體之(zhi)扶(fu)(fu)持,謂其(qi)對扶(fu)(fu)持人體與治療下(xia)肢風病(bing)(bing)(bing),俱可(ke)承(cheng)擔也(ye),在(zai)下(xia)肢風病(bing)(bing)(bing)及風病(bing)(bing)(bing)之(zhi)自下(xia)而(er)上者,皆可(ke)取之(zhi)。提攜嬰兒,負之(zhi)抱之(zhi),均以手(shou)承(cheng)扶(fu)(fu)其(qi)臀,本穴在(zai)臀橫紋正(zheng)中(zhong),適(shi)當挾持著手(shou)之(zhi)處,故(gu)名(ming)承(cheng)扶(fu)(fu)。[9]
承扶穴(xue)位于股后區,臀溝的中點,俯臥取之[7]。
承扶穴(xue)在足太陽膀胱經中(zhong)的位(wei)置
承扶穴在大腿的位置
承扶穴在大腿的位置
承(cheng)扶穴(xue)在大(da)腿的位置(肌(ji)肉(rou))
承(cheng)扶穴(xue)在(zai)大腿的(de)位置(骨骼、神經、血管(guan))
承扶穴(xue)位于(yu)股后區,臀溝(gou)的中點。俯臥取之(zhi)[7]。
俯臥位,于大(da)腿與臀(tun)(tun)部交界之(zhi)臀(tun)(tun)溝中點處取穴[11]。
5.7.1層(ceng)次解剖 皮膚→皮下(xia)組織→臀大肌→股二頭(tou)肌長頭(tou)及(ji)半腱肌[7]。
5.7.2穴區神經(jing)、血(xue)管(guan) 淺(qian)層(ceng)(ceng)有股后皮(pi)神經(jing)的分支分布;深層(ceng)(ceng)有臀下神經(jing)和(he)臀下動脈分支分布,并有坐(zuo)骨神經(jing)本(ben)干和(he)股后皮(pi)神經(jing)本(ben)干經(jing)過;
布(bu)有(you)股后皮神經,深(shen)層為坐(zuo)骨神經;并有(you)與坐(zuo)骨神經并行的動、靜(jing)脈(mo)通過[8]。
人體體表面積計算器BMI指數計算及評價女性安全期計算器預產期計算器孕期體重增長正常值孕期用藥安全性分級(FDA)五行八字成人血壓評價體溫水平評價糖尿病飲食建議臨床生化常用單位換算基礎代謝率計算補鈉計算器補鐵計算器處方常用拉丁文縮寫速查藥代動力學常用符號速查有效血漿滲透壓計算器乙醇攝入量計算器
醫學(xue)百科,馬上計(ji)算!
承扶穴(xue)有舒筋活絡的作(zuo)用[7]。
承扶(fu)穴具有通(tong)經(jing)活絡、疏利腰膝之功,為治療腰腿部疾(ji)病的常用腧穴[12]。
承扶穴對肢體(ti)風(feng)病具(ju)有(you)攔截之(zhi)(zhi)(zhi)效,有(you)舒經(jing)(jing)(jing)活(huo)絡(luo)之(zhi)(zhi)(zhi)用,主治(zhi)尻尾股臀、陰寒大(da)痛。因本經(jing)(jing)(jing)與(yu)足少(shao)陰經(jing)(jing)(jing)俱由委中至腎俞(yu),此段(duan)經(jing)(jing)(jing)線,兩經(jing)(jing)(jing)并行(xing)。疊成(cheng)一(yi)表一(yi)里(li),故(gu)淺(qian)取(qu)之(zhi)(zhi)(zhi)則足太陽之(zhi)(zhi)(zhi)經(jing)(jing)(jing)受之(zhi)(zhi)(zhi),深取(qu)之(zhi)(zhi)(zhi)則足少(shao)陰之(zhi)(zhi)(zhi)經(jing)(jing)(jing)受之(zhi)(zhi)(zhi)。[9]
承扶穴主治腰腿部疾患。如(ru)腰腿疼痛、下肢痿痹、痔瘡出血、小(xiao)便(bian)不利、大便(bian)秘結(jie)等[7]。
承扶穴主(zhu)治腰骶臀股部疼痛、痔疾[13][13]。
承扶穴主治腰(yao)腿痛,下肢痿(wei)痹(bi);痔疾[11]。
現代又多用承扶穴(xue)治(zhi)療腰(yao)背神經痛(tong)、坐骨神經痛(tong)、小兒麻痹(bi)后(hou)遺癥等[7]。
承扶穴主治(zhi)腰、骶、臀、股部疼痛,痔疾,大便(bian)難;以(yi)及坐(zuo)骨神經痛,下肢(zhi)麻痹(bi)或癱(tan)瘓等(deng)[8]。
1. 精(jing)神神經系統(tong)疾病:坐骨神經痛,腰骶神經根炎,下肢癱瘓(huan),小兒麻痹后遺癥;
2. 其它:便(bian)秘,痔瘡,尿潴留,臀(tun)部炎(yan)癥等(deng)。
直刺(ci)1~2.5寸(cun)[13]。
5.10.2灸(jiu)法 可灸(jiu)[7][13][11]。
艾炷灸3~5壯(zhuang);或(huo)艾條灸5~10分鐘(zhong)[8]。
艾炷灸(jiu)或溫針灸(jiu)5~7壯,艾條(tiao)溫灸(jiu)10~15分鐘。
承扶配秩(zhi)邊、承山,有清熱通(tong)便(bian)的作(zuo)用,主(zhu)治便(bian)秘。
承扶配腎俞、命門(men)、腰陽關(guan),治(zhi)腰痛[11]。
承扶配腎(shen)俞(yu)、環(huan)跳、風市、陽陵(ling)泉、足三里、三陰交,治下(xia)肢癱瘓[11]。
《銅(tong)人腧穴(xue)針灸圖經》:小便不利。
《針灸(jiu)大成》:久痔(zhi)尻臀腫。
《太平圣惠方》:五(wu)種痔疾,瀉(xie)鮮血,尻睢(sui)中腫,大便難,小便不利(li)。
針刺(ci)承扶,可見(jian)動物腦組織內氨含量顯著增(zeng)加,提示(shi)腦功能處于短期興奮狀態[9]。
針刺(ci)承扶穴也可使麻醉動(dong)物已(yi)降低的腦乳(ru)酸明顯升高,又可使驚厥(jue)狀態下腦乳(ru)酸的高值下降[9]。
電針承扶可見動物垂(chui)體利尿(niao)激(ji)素的(de)分泌增(zeng)強,腎上腺組織(zhi)中(zhong)抗壞血酸、膽固醇以及周(zhou)圍血液中(zhong)嗜酸性白細(xi)胞明顯減(jian)少(shao)[9]。
目(mu)錄(lu)1拼音2英(ying)文參(can)考3概(gai)述4太陽病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)5陽明病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)6少(shao)(shao)陽病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)7太陰病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)8少(shao)(shao)陰病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)9厥陰病(bing)(bing)(bing)·六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)10參(can)考資料附:1治(zhi)(zhi)療(liao)六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)的穴(xue)位2治(zhi)(zhi)療(liao)六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)的方劑3治(zhi)(zhi)療(liao)六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)的中(zhong)成藥4六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing)相(xiang)關(guan)藥物5古籍中(zhong)的六(liu)經(jing)(jing)(jing)病(bing)(bing)(bing) 1拼音 liù jīng bìng
2英(ying)文參(can)考(kao) diseases of six meridians [湘(xiang)雅醫學專(zhuan)業詞典]
3概述(shu) 六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)病(bing)(bing)(bing)為(wei)病(bing)(bing)(bing)名[1]。指太陽病(bing)(bing)(bing)、陽明病(bing)(bing)(bing)、少(shao)陽病(bing)(bing)(bing)、太陰(yin)病(bing)(bing)(bing)、少(shao)陰(yin)病(bing)(bing)(bing)、厥陰(yin)病(bing)(bing)(bing)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)病(bing)(bing)(bing)證(zheng)(zheng)[1]。《傷(shang)(shang)寒(han)(han)(han)論(lun)》中(zhong)(zhong)把外感疾病(bing)(bing)(bing)在(zai)發展、變(bian)化過程中(zhong)(zhong)所(suo)產生的(de)各種(zhong)證(zheng)(zheng)候,依據(ju)所(suo)侵(qin)犯的(de)經(jing)(jing)(jing)(jing)(jing)(jing)絡、臟腑病(bing)(bing)(bing)變(bian)部(bu)位,受邪輕重(zhong),邪正盛衰,劃(hua)分為(wei)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)病(bing)(bing)(bing)證(zheng)(zheng),以(yi)之(zhi)(zhi)分辨陰(yin)陽、表里、寒(han)(han)(han)熱(re)、虛實(shi),指出各經(jing)(jing)(jing)(jing)(jing)(jing)的(de)主要(yao)脈(mo)證(zheng)(zheng)、治法(fa)及其(qi)(qi)傳(chuan)變(bian)規(gui)律,進行辨證(zheng)(zheng)論(lun)治[1]。并對診治雜病(bing)(bing)(bing)也有(you)指導意義[1]。《傷(shang)(shang)寒(han)(han)(han)論(lun)翼》卷(juan)上(shang):“六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)之(zhi)(zhi)為(wei)病(bing)(bing)(bing),不(bu)是(shi)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)之(zhi)(zhi)傷(shang)(shang)寒(han)(han)(han),乃是(shi)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)分司諸病(bing)(bing)(bing)之(zhi)(zhi)提綱,非(fei)專為(wei)傷(shang)(shang)寒(han)(han)(han)一癥主法(fa)也。……夫仲景之(zhi)(zhi)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing),是(shi)分六(liu)(liu)(liu)(liu)區(qu)地面,所(suo)該者(zhe)廣(guang),雖以(yi)脈(mo)為(wei)經(jing)(jing)(jing)(jing)(jing)(jing)絡,而不(bu)專在(zai)經(jing)(jing)(jing)(jing)(jing)(jing)絡上(shang)立說(shuo),凡風寒(han)(han)(han)溫熱(re)內傷(shang)(shang)外感,自(zi)表及里,有(you)寒(han)(han)(han)有(you)熱(re),或(huo)虛或(huo)實(shi),無(wu)乎不(bu)包。”六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)分手足(zu)(zu),為(wei)十(shi)二經(jing)(jing)(jing)(jing)(jing)(jing)[1]。古代有(you)些醫家,有(you)傷(shang)(shang)寒(han)(han)(han)傳(chuan)足(zu)(zu)不(bu)傳(chuan)手之(zhi)(zhi)說(shuo)[1]。《類(lei)經(jing)(jing)(jing)(jing)(jing)(jing)·傷(shang)(shang)寒(han)(han)(han)》:“周(zhou)身(shen)上(shang)下(xia)脈(mo)絡,惟足(zu)(zu)六(liu)(liu)(liu)(liu)經(jing)(jing)(jing)(jing)(jing)(jing)則(ze)盡(jin)之(zhi)(zhi)矣。手經(jing)(jing)(jing)(jing)(jing)(jing)無(wu)能遍也,且手經(jing)(jing)(jing)(jing)(jing)(jing)所(suo)至(zhi),足(zu)(zu)經(jing)(jing)(jing)(jing)(jing)(jing)無(wu)不(bu)至(zhi)者(zhe),故但言足(zu)(zu)經(jing)(jing)(jing)(jing)(jing)(jing),則(ze)其(qi)(qi)左右前后(hou)陰(yin)陽諸證(zheng)(zheng),無(wu)不(bu)可按而得,而手經(jing)(jing)(jing)(jing)(jing)(jing)亦(yi)在(zai)其(qi)(qi)中(zhong)(zhong)。”
4太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)病(bing)(bing)·六(liu)經(jing)(jing)病(bing)(bing) 太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)病(bing)(bing)為(wei)(wei)病(bing)(bing)名[2]。《傷(shang)(shang)(shang)(shang)寒(han)(han)(han)論》六(liu)經(jing)(jing)病(bing)(bing)之(zhi)(zhi)一(yi)[2]。太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)病(bing)(bing)包括經(jing)(jing)證(zheng)和(he)(he)腑證(zheng)[2]。多由外(wai)感風(feng)(feng)(feng)寒(han)(han)(han)所致(zhi)[2]。經(jing)(jing)病(bing)(bing)包括太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)中風(feng)(feng)(feng)與太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)傷(shang)(shang)(shang)(shang)寒(han)(han)(han),腑病(bing)(bing)包括太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)蓄(xu)(xu)水(shui)證(zheng)和(he)(he)太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)蓄(xu)(xu)血證(zheng)[2]。《尚論篇(pian)》卷一(yi):“太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)病(bing)(bing)之(zhi)(zhi)總(zong)脈總(zong)證(zheng),統中風(feng)(feng)(feng)傷(shang)(shang)(shang)(shang)寒(han)(han)(han)為(wei)(wei)言也(ye)(ye)。太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang),膀胱經(jing)(jing),乃六(liu)經(jing)(jing)之(zhi)(zhi)首,主皮膚而(er)統營(ying)衛(wei)(wei),所以(yi)為(wei)(wei)受(shou)病(bing)(bing)之(zhi)(zhi)始。”《傷(shang)(shang)(shang)(shang)寒(han)(han)(han)指掌》卷一(yi):“凡風(feng)(feng)(feng)寒(han)(han)(han)初感,先入皮毛肌表(biao)(biao)(biao),外(wai)癥(zheng)(zheng)便有頭(tou)痛,項強,身(shen)痛,腰痛,骨節煩疼,發熱,惡寒(han)(han)(han),此皆太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)經(jing)(jing)之(zhi)(zhi)見癥(zheng)(zheng)。如(ru)無汗(han)而(er)脈浮緊,此營(ying)衛(wei)(wei)俱強而(er)表(biao)(biao)(biao)實也(ye)(ye),用麻黃湯以(yi)發表(biao)(biao)(biao),使營(ying)衛(wei)(wei)之(zhi)(zhi)邪,從皮毛而(er)出,則諸癥(zheng)(zheng)自(zi)除矣;如(ru)脈浮而(er)弱,汗(han)自(zi)出者,此營(ying) *** 弱而(er)表(biao)(biao)(biao)虛也(ye)(ye),用桂枝湯以(yi)解肌,使營(ying)衛(wei)(wei)和(he)(he),而(er)邪自(zi)解矣。”《傷(shang)(shang)(shang)(shang)寒(han)(han)(han)醫訣串(chuan)解·太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)篇(pian)》:“太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)為(wei)(wei)寒(han)(han)(han)水(shui)之(zhi)(zhi)經(jing)(jing),主一(yi)身(shen)之(zhi)(zhi)表(biao)(biao)(biao)。何謂太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)經(jing)(jing)證(zheng)?曰(yue)頭(tou)痛、項強、發熱、惡寒(han)(han)(han)是也(ye)(ye)。……何謂太(tai)(tai)(tai)(tai)(tai)陽(yang)(yang)(yang)腑證(zheng)?曰(yue)表(biao)(biao)(biao)邪不去,必(bi)人于里,膀胱為(wei)(wei)表(biao)(biao)(biao)中之(zhi)(zhi)里也(ye)(ye),有蓄(xu)(xu)水(shui)、蓄(xu)(xu)血之(zhi)(zhi)辨。”
5陽(yang)明(ming)病(bing)(bing)(bing)(bing)·六經(jing)(jing)病(bing)(bing)(bing)(bing) 陽(yang)明(ming)病(bing)(bing)(bing)(bing)為病(bing)(bing)(bing)(bing)名[3]。六經(jing)(jing)病(bing)(bing)(bing)(bing)之(zhi)一[3]。《傷寒論·辨陽(yang)明(ming)病(bing)(bing)(bing)(bing)脈(mo)證(zheng)并治(zhi)(zhi)》:“陽(yang)明(ming)之(zhi)為病(bing)(bing)(bing)(bing),胃(wei)家(jia)實是(shi)也(ye)。”胃(wei)家(jia),泛指(zhi)腸胃(wei)而(er)言;實,是(shi)邪(xie)氣實[3]。陽(yang)明(ming)病(bing)(bing)(bing)(bing)一般(ban)主里、熱(re)(re)(re)(re)(re)(re)、實證(zheng)[3]。辨證(zheng)有(you)經(jing)(jing)證(zheng)、府(fu)(fu)證(zheng)之(zhi)分(fen)[3]。《傷寒貫(guan)珠集·陽(yang)明(ming)篇上》:“陽(yang)明(ming)則府(fu)(fu)病(bing)(bing)(bing)(bing)多于(yu)經(jing)(jing)病(bing)(bing)(bing)(bing)。以經(jing)(jing)邪(xie)不(bu)能久(jiu)留,而(er)府(fu)(fu)邪(xie)常聚而(er)不(bu)行也(ye)……經(jing)(jing)病(bing)(bing)(bing)(bing)有(you)傳經(jing)(jing)、自(zi)受之(zhi)不(bu)同(tong),府(fu)(fu)病(bing)(bing)(bing)(bing)有(you)宜(yi)下、宜(yi)清(qing)(qing)、宜(yi)溫之(zhi)各(ge)異。”陽(yang)明(ming)經(jing)(jing)證(zheng)因(yin)無(wu)形的邪(xie)熱(re)(re)(re)(re)(re)(re)盛(sheng)于(yu)經(jing)(jing),證(zheng)見身大熱(re)(re)(re)(re)(re)(re),汗大出,大煩渴,脈(mo)洪(hong)大等[3]。治(zhi)(zhi)宜(yi)清(qing)(qing)熱(re)(re)(re)(re)(re)(re)保(bao)津(jin)為主,常用(yong)(yong)白虎湯(tang)等方(fang)[3]。陽(yang)明(ming)府(fu)(fu)證(zheng)是(shi)有(you)形的燥實熱(re)(re)(re)(re)(re)(re)結(jie)于(yu)腑,證(zheng)見潮(chao)熱(re)(re)(re)(re)(re)(re)、譫語(yu)、腹滿痛(tong)、不(bu)大便、脈(mo)沉實等[3]。治(zhi)(zhi)當攻下燥實,清(qing)(qing)除熱(re)(re)(re)(re)(re)(re)結(jie),常用(yong)(yong)三承氣湯(tang)等方(fang)[3]。陽(yang)明(ming)病(bing)(bing)(bing)(bing)由于(yu)里熱(re)(re)(re)(re)(re)(re)外(wai)蒸,故不(bu)惡寒而(er)反惡熱(re)(re)(re)(re)(re)(re),是(shi)陽(yang)明(ming)病(bing)(bing)(bing)(bing)的發熱(re)(re)(re)(re)(re)(re)特征[3]。在治(zhi)(zhi)療上,因(yin)陽(yang)熱(re)(re)(re)(re)(re)(re)亢(kang)盛(sheng),津(jin)液(ye)容易耗傷,故清(qing)(qing)、下二法,為陽(yang)明(ming)病(bing)(bing)(bing)(bing)的重(zhong)要治(zhi)(zhi)法[3]。
6少(shao)(shao)(shao)陽(yang)(yang)病(bing)(bing)·六(liu)經(jing)(jing)病(bing)(bing) 少(shao)(shao)(shao)陽(yang)(yang)病(bing)(bing)為病(bing)(bing)名[4]。六(liu)經(jing)(jing)病(bing)(bing)之(zhi)一[4]。由邪(xie)(xie)(xie)熱(re)(re)(re)(re)在(zai)半(ban)表(biao)(biao)(biao)半(ban)里(li)所致[4]。本病(bing)(bing)特征是口(kou)(kou)苦(ku),咽干(gan),目眩,往(wang)來(lai)寒(han)(han)(han)熱(re)(re)(re)(re),胸脅(xie)(xie)苦(ku)滿,心煩喜嘔,嘿(hei)嘿(hei)不欲飲食,脈(mo)弦等[4]。《傷(shang)(shang)寒(han)(han)(han)論·辨少(shao)(shao)(shao)陽(yang)(yang)病(bing)(bing)脈(mo)證(zheng)(zheng)并治》:“少(shao)(shao)(shao)陽(yang)(yang)之(zhi)為病(bing)(bing),口(kou)(kou)苦(ku),咽干(gan),目眩也。”又“本太(tai)陽(yang)(yang)病(bing)(bing)不解(jie),轉入少(shao)(shao)(shao)陽(yang)(yang)者,脅(xie)(xie)下(xia)鞕滿,干(gan)嘔不能食,往(wang)來(lai)寒(han)(han)(han)熱(re)(re)(re)(re),尚(shang)未(wei)吐下(xia),脈(mo)沉緊者,與小柴(chai)胡湯(tang)。”《注解(jie)傷(shang)(shang)寒(han)(han)(han)論》卷三(san):“邪(xie)(xie)(xie)因正(zheng)(zheng)虛,自表(biao)(biao)(biao)之(zhi)里(li),而結于(yu)脅(xie)(xie)下(xia),與正(zheng)(zheng)分爭(zheng),作往(wang)來(lai)寒(han)(han)(han)熱(re)(re)(re)(re)。”《傷(shang)(shang)寒(han)(han)(han)微旨論·傷(shang)(shang)寒(han)(han)(han)源篇》:“少(shao)(shao)(shao)陽(yang)(yang)受之(zhi),少(shao)(shao)(shao)陽(yang)(yang)主膽(dan),故(gu)胸脅(xie)(xie)痛(tong)而耳聾。”《傷(shang)(shang)寒(han)(han)(han)辨證(zheng)(zheng)》卷四:“邪(xie)(xie)(xie)在(zai)半(ban)表(biao)(biao)(biao)半(ban)里(li),則(ze)(ze)惡寒(han)(han)(han)且熱(re)(re)(re)(re),故(gu)令寒(han)(han)(han)熱(re)(re)(re)(re)往(wang)來(lai)。少(shao)(shao)(shao)陽(yang)(yang)之(zhi)脈(mo)行于(yu)兩脅(xie)(xie),故(gu)令脅(xie)(xie)痛(tong)。其經(jing)(jing)屬于(yu)膽(dan),膽(dan)汁上溢(yi),故(gu)口(kou)(kou)苦(ku)。”《張氏醫通(tong)·諸傷(shang)(shang)門》:“若交少(shao)(shao)(shao)陽(yang)(yang)之(zhi)經(jing)(jing),則(ze)(ze)往(wang)來(lai)寒(han)(han)(han)熱(re)(re)(re)(re),口(kou)(kou)苦(ku)脅(xie)(xie)痛(tong),以(yi)其經(jing)(jing)居表(biao)(biao)(biao)里(li)之(zhi)半(ban),邪(xie)(xie)(xie)欲入則(ze)(ze)寒(han)(han)(han),正(zheng)(zheng)與爭(zheng)則(ze)(ze)熱(re)(re)(re)(re),所以(yi)只宜和解(jie),而有(you)汗、下(xia)、利小便(bian)三(san)禁。”本病(bing)(bing)多兼(jian)證(zheng)(zheng)[4]。若有(you)太(tai)陽(yang)(yang)表(biao)(biao)(biao)證(zheng)(zheng)時可兼(jian)用(yong)汗法(fa),如(ru)柴(chai)胡桂枝湯(tang)證(zheng)(zheng);若有(you)陽(yang)(yang)明(ming)里(li)證(zheng)(zheng)時可兼(jian)用(yong)下(xia)法(fa),如(ru)大柴(chai)胡湯(tang)證(zheng)(zheng)、柴(chai)胡加芒硝湯(tang)證(zheng)(zheng)等[4]。
7太(tai)陰(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)·六經病(bing)(bing)(bing)(bing)(bing) 太(tai)陰(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)為(wei)(wei)(wei)(wei)(wei)病(bing)(bing)(bing)(bing)(bing)名[5]。《傷(shang)(shang)(shang)寒(han)(han)(han)論(lun)》六經病(bing)(bing)(bing)(bing)(bing)之(zhi)(zhi)(zhi)(zhi)(zhi)一[5]。多因(yin)三(san)陽(yang)(yang)(yang)(yang)病(bing)(bing)(bing)(bing)(bing)傳(chuan)經入里,或(huo)寒(han)(han)(han)邪直中,或(huo)內(nei)傷(shang)(shang)(shang)生冷所致[5]。其特征是(shi)(shi)腹(fu)(fu)(fu)滿而吐(tu),食不(bu)下(xia)(xia),自(zi)利,時(shi)有(you)腹(fu)(fu)(fu)痛(tong)等[5]。《傷(shang)(shang)(shang)寒(han)(han)(han)論(lun)·辨太(tai)陰(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)脈證并治》:“太(tai)陰(yin)(yin)(yin)之(zhi)(zhi)(zhi)(zhi)(zhi)為(wei)(wei)(wei)(wei)(wei)病(bing)(bing)(bing)(bing)(bing),腹(fu)(fu)(fu)滿而吐(tu),食不(bu)下(xia)(xia),自(zi)利益甚,時(shi)腹(fu)(fu)(fu)自(zi)痛(tong)。”《傷(shang)(shang)(shang)寒(han)(han)(han)分經》卷(juan)三(san):“太(tai)陰(yin)(yin)(yin)為(wei)(wei)(wei)(wei)(wei)寒(han)(han)(han)臟(zang),其宜(yi)溫(wen)之(zhi)(zhi)(zhi)(zhi)(zhi)證為(wei)(wei)(wei)(wei)(wei)最多,非一方可盡,故曰,宜(yi)服四(si)逆(ni)(ni)輩(bei),則理中、真(zhen)武、附(fu)子等湯,俱可隨證用之(zhi)(zhi)(zhi)(zhi)(zhi)矣。”《傷(shang)(shang)(shang)寒(han)(han)(han)附(fu)翼(yi)·太(tai)陰(yin)(yin)(yin)方總論(lun)》:“其來由(you)有(you)三(san):有(you)因(yin)表虛(xu)(xu)而風寒(han)(han)(han)自(zi)外入者(zhe);有(you)因(yin)下(xia)(xia)虛(xu)(xu)而寒(han)(han)(han)濕自(zi)下(xia)(xia)上(shang)者(zhe);有(you)因(yin)飲食生冷而寒(han)(han)(han)邪由(you)中發者(zhe)。總不(bu)出于(yu)虛(xu)(xu)寒(han)(han)(han),法當溫(wen)補以扶胃脘之(zhi)(zhi)(zhi)(zhi)(zhi)陽(yang)(yang)(yang)(yang),一理中而滿痛(tong)吐(tu)利諸(zhu)癥悉平(ping)矣。”一說,太(tai)陰(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)有(you)陰(yin)(yin)(yin)陽(yang)(yang)(yang)(yang)虛(xu)(xu)實之(zhi)(zhi)(zhi)(zhi)(zhi)分[5]。《傷(shang)(shang)(shang)寒(han)(han)(han)貫珠集》卷(juan)六:“然(ran)太(tai)陰(yin)(yin)(yin)為(wei)(wei)(wei)(wei)(wei)病(bing)(bing)(bing)(bing)(bing),不(bu)特傳(chuan)經如(ru)(ru)是(shi)(shi),即直中亦如(ru)(ru)是(shi)(shi),且不(bu)特傷(shang)(shang)(shang)寒(han)(han)(han)如(ru)(ru)是(shi)(shi),即雜病(bing)(bing)(bing)(bing)(bing)亦如(ru)(ru)是(shi)(shi),但有(you)屬陰(yin)(yin)(yin)屬陽(yang)(yang)(yang)(yang),為(wei)(wei)(wei)(wei)(wei)盛為(wei)(wei)(wei)(wei)(wei)虛(xu)(xu)之(zhi)(zhi)(zhi)(zhi)(zhi)分耳。”《傷(shang)(shang)(shang)寒(han)(han)(han)醫訣串解》卷(juan)四(si):“太(tai)陰(yin)(yin)(yin)為(wei)(wei)(wei)(wei)(wei)濕土,純陰(yin)(yin)(yin)之(zhi)(zhi)(zhi)(zhi)(zhi)臟(zang)也(ye),從(cong)(cong)陰(yin)(yin)(yin)化者(zhe)多,從(cong)(cong)陽(yang)(yang)(yang)(yang)化者(zhe)少。病(bing)(bing)(bing)(bing)(bing)人(ren)太(tai)陰(yin)(yin)(yin),何謂太(tai)陰(yin)(yin)(yin)之(zhi)(zhi)(zhi)(zhi)(zhi)邪從(cong)(cong)陰(yin)(yin)(yin)化?《傷(shang)(shang)(shang)寒(han)(han)(han)論(lun)》云:腹(fu)(fu)(fu)滿,吐(tu)食,自(zi)利,不(bu)渴(ke),手足(zu)自(zi)溫(wen),時(shi)腹(fu)(fu)(fu)自(zi)痛(tong)是(shi)(shi)也(ye),宜(yi)理中丸、湯主(zhu)之(zhi)(zhi)(zhi)(zhi)(zhi),不(bu)愈(yu)宜(yi)四(si)逆(ni)(ni)輩(bei)。病(bing)(bing)(bing)(bing)(bing)人(ren)太(tai)陰(yin)(yin)(yin)之(zhi)(zhi)(zhi)(zhi)(zhi)邪從(cong)(cong)陽(yang)(yang)(yang)(yang)化,《傷(shang)(shang)(shang)寒(han)(han)(han)論(lun)》云:發汗后不(bu)解,腹(fu)(fu)(fu)痛(tong),急(ji)下(xia)(xia)之(zhi)(zhi)(zhi)(zhi)(zhi),宜(yi)大承氣湯是(shi)(shi)也(ye)。”從(cong)(cong)陽(yang)(yang)(yang)(yang)化,即指太(tai)陰(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)轉為(wei)(wei)(wei)(wei)(wei)陽(yang)(yang)(yang)(yang)明病(bing)(bing)(bing)(bing)(bing)[5]。
8少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)·六經病(bing)(bing)(bing)(bing)(bing)(bing) 少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)為(wei)(wei)病(bing)(bing)(bing)(bing)(bing)(bing)名[6]。六經病(bing)(bing)(bing)(bing)(bing)(bing)之(zhi)(zhi)一(yi)[6]。多(duo)因(yin)邪傳少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin),心腎(shen)陽(yang)(yang)(yang)(yang)氣(qi)(qi)衰微,陰(yin)(yin)(yin)(yin)(yin)(yin)寒(han)內盛(sheng)所致(zhi)[6]。本(ben)病(bing)(bing)(bing)(bing)(bing)(bing)特征是(shi)脈(mo)微細,但欲寐(mei),四肢逆冷,下利清谷(gu)(gu),甚至汗出亡陽(yang)(yang)(yang)(yang)等[6]。《傷寒(han)論·辨少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)脈(mo)證(zheng)并治》:“少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)之(zhi)(zhi)為(wei)(wei)病(bing)(bing)(bing)(bing)(bing)(bing),脈(mo)微細,但欲寐(mei)也(ye)(ye)。”《注解傷寒(han)論》卷六:“少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)為(wei)(wei)病(bing)(bing)(bing)(bing)(bing)(bing),脈(mo)微細,為(wei)(wei)邪氣(qi)(qi)傳里深也(ye)(ye)。衛氣(qi)(qi)行于(yu)陽(yang)(yang)(yang)(yang)則(ze)寤,行于(yu)陰(yin)(yin)(yin)(yin)(yin)(yin)則(ze)寐(mei)。邪傳少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin),則(ze)氣(qi)(qi)行于(yu)陰(yin)(yin)(yin)(yin)(yin)(yin)而(er)不行于(yu)陽(yang)(yang)(yang)(yang),故(gu)但欲寐(mei)。”《傷寒(han)指掌》卷二:“少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)證(zheng),仲(zhong)景以脈(mo)微細,但欲寐(mei)為(wei)(wei)主病(bing)(bing)(bing)(bing)(bing)(bing)。此指正氣(qi)(qi)之(zhi)(zhi)虛(xu),非示邪氣(qi)(qi)之(zhi)(zhi)實也(ye)(ye)。……引衣蜷臥,下利清谷(gu)(gu),腹痛吐瀉,是(shi)少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)虛(xu)寒(han)見(jian)證(zheng)。”治宜溫經回(hui)陽(yang)(yang)(yang)(yang),如四逆湯等方(fang)[6]。其病(bing)(bing)(bing)(bing)(bing)(bing)可(ke)從三陽(yang)(yang)(yang)(yang)病(bing)(bing)(bing)(bing)(bing)(bing)傳變而(er)致(zhi),亦(yi)有因(yin)寒(han)邪直中少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)引起(qi)[6]。少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)病(bing)(bing)(bing)(bing)(bing)(bing)如見(jian)陰(yin)(yin)(yin)(yin)(yin)(yin)虛(xu)火旺,為(wei)(wei)熱(re)傷腎(shen)陰(yin)(yin)(yin)(yin)(yin)(yin)證(zheng)[6]。《傷寒(han)溯源集·少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)熱(re)證(zheng)》:“熱(re)邪內郁而(er)心煩(fan)(fan)不得臥,致(zhi)手足(zu)兩少(shao)(shao)陰(yin)(yin)(yin)(yin)(yin)(yin)俱受病(bing)(bing)(bing)(bing)(bing)(bing)也(ye)(ye),以黃連阿膠(jiao)湯主之(zhi)(zhi)者,所以瀉心家之(zhi)(zhi)煩(fan)(fan)熱(re),益腎(shen)臟之(zhi)(zhi)真陰(yin)(yin)(yin)(yin)(yin)(yin)也(ye)(ye)。”
9厥(jue)(jue)陰(yin)病(bing)·六經病(bing) 厥(jue)(jue)陰(yin)病(bing)為(wei)《傷寒(han)(han)論(lun)》六經病(bing)之一(yi)[7]。它(ta)是陰(yin)陽消長(chang)、邪正(zheng)進退(tui)的(de)重要(yao)關鍵,所以(yi)常出現寒(han)(han)熱(re)錯雜(za)的(de)證候[7]。主要(yao)有(you)上(shang)熱(re)下(xia)寒(han)(han)與厥(jue)(jue)熱(re)勝(sheng)復(fu)兩類(lei)情(qing)況(kuang)[7]。上(shang)熱(re)下(xia)寒(han)(han)者(zhe),癥見(jian)消渴,氣上(shang)撞心(xin),心(xin)中疼熱(re),饑而(er)不(bu)欲(yu)食,下(xia)利及吐蛔等,治(zhi)宜清上(shang)溫下(xia)[7]。厥(jue)(jue)熱(re)勝(sheng)復(fu)者(zhe),可預測病(bing)情(qing)的(de)進退(tui),厥(jue)(jue)多(duo)熱(re)少為(wei)病(bing)進,厥(jue)(jue)少熱(re)多(duo)為(wei)病(bing)退(tui),故(gu)其(qi)治(zhi)法當(dang)以(yi)扶陽抑陰(yin)為(wei)主[7]。陽虛寒(han)(han)厥(jue)(jue),見(jian)脈微惡寒(han)(han),手足(zu)厥(jue)(jue)冷者(zhe),治(zhi)宜回陽救逆;血虛寒(han)(han)厥(jue)(jue),見(jian)手足(zu)厥(jue)(jue)寒(han)(han)、脈細欲(yu)絕(jue)者(zhe),治(zhi)宜養(yang)血和營、通陽散寒(han)(han)[7]。陽氣內郁,以(yi)致手足(zu)厥(jue)(jue)逆,心(xin)下(xia)痞(pi)塞,胸脅苦滿,或腹中痛,脈弦有(you)力者(zhe),治(zhi)宜疏肝(gan)泄熱(re)退(tui)厥(jue)(jue)[7]。
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