《金匮要略》上气证治探讨

刘明佳; 马勇

doi:10.14148/j.issn.1672-0482.2024.0006

《金匮要略》上气证治探讨

doi: 10.14148/j.issn.1672-0482.2024.0006

刘明佳,
马勇^,

南京中医药大学中医学院，江苏南京 210023

基金项目:

南京中医药大学本科教育教学改革重大课题教字〔2022〕65号

详细信息

作者简介:
刘明佳，女，硕士研究生, E-mail: 101055146@qq.com

通讯作者:
马勇，男，教授，主要从事创伤及慢性筋骨病的研究，E-mail: 260758@njucm.edu.cn

中图分类号: R222.3
计量
- 文章访问数: 177
- HTML全文浏览量: 32
- PDF下载量: 33
- 被引次数: 0
出版历程
- 收稿日期: 2023-04-28
- 网络出版日期: 2024-01-24
- 发布日期: 2024-01-10

Syndromes and Treatment of Shang Qi from Essentials from the Golden Cabinet

LIU Mingjia,
MA Yong^,

School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China

摘要

摘要: 上气一词首见于《黄帝内经》，《金匮要略》对上气诊治作了系统的论述，但后世医家对上气的词义认识不够统一。通过疏理《黄帝内经》《金匮要略》相关条文，参考医学典籍，结合临床实际，认为《金匮要略》中的上气有病名及症状双重含义。作为疾病，其病位在肺，症状特点为气上冲，常引起咳嗽，或与咳、喘伴随发生，病机有寒、热、虚、实之别，《金匮要略》针对上气分为寒饮郁肺、饮热郁肺、虚热犯肺、痰饮壅肺四证进行辨治，既重视病机，亦重视药证的对应。故对经方证治的认识和理解，应辨证与方证互参，方能贯通经方之理法方药。
- 金匮要略 /
- 上气 /
- 上气证治
Abstract: The term "shang qi" first appeared in The Yellow Emperor's Inner Classic, and Essentials from the Golden Cabinet made a systematic discussion on the syndromes and treatment of "shang qi", but later generations of physicians did not have a deep and unified understanding of the meaning of "shang qi". By combining the relevant provisions of The Yellow Emperor's Inner Classic and Essentials from the Golden Cabinet, referring to medical texts and combining with clinical reality, the author believes that the "shang gi" in Essentials from the Golden Cabinet has dual meanings of disease name and syndrome. As a disease, it is a symptom of "qi rush" that occurs in the lungs, often causing cough or accompanying cough and wheezing. The pathogenesis of "shang qi" can be divided into cold, heat, deficiency and excess. Essentials from the Golden Cabinet focuses on the differentiation and treatment of the four syndromes of "shang gi": cold fluid stagnation of the lungs, fluid heat stagnation of the lungs, deficiency heat invasion of the lungs, and phlegm turbidity obstruction of the lungs, attaching importance to both the pathogenesis and the correspondence between medication and syndrome. Therefore, the understanding of the treatment of classic prescriptions should be based on syndrome differentiation and mutual reference between formulas and syndromes, in order to integrate the principles, methods, and medicines of classic prescriptions.
- Essentials from the Golden Cabinet /
- shang qi /
- syndromes and treatment of shang qi

HTML全文

参考文献(34)

[1]	黄帝内经灵枢[M]. 福州: 福建科学技术出版社, 2012. The Yellow emperor's inner classic miraculous pivot[M]. Fuzhou: Fujian Science and Technology Press, 2012.
[2]	王冰. 黄帝内经素问[M]. 郑州: 河南科学技术出版社, 2017. WANG B. The Yellow emperor's inner classic plain questions[M]. Zhengzhou: Henan Science and Technology Press, 2017.
[3]	吴谦. 医宗金鉴·订正仲景全书[M]. 北京: 人民卫生出版社, 1973. WU Q. Golden mirror of medicine: Revised zhongjing complete book[M]. Beijing: People's Medical Publishing House, 1973.
[4]	李飞. 仲景治咳嗽上气方评述[J]. 南京中医药大学学报, 2017, 33(5): 476-479. http://xb.njucm.edu.cn/article/id/ZR2017_0508 LI F. Comment on Zhongjing's formula for treating cough due to abnormal rise of qi[J]. J Nanjing Univ Tradit Chin Med, 2017, 33(5): 476-479. http://xb.njucm.edu.cn/article/id/ZR2017_0508
[5]	孟翔, 王真. 王真治疗咳嗽变异型哮喘经验[J]. 浙江中西医结合杂志, 2022, 32(7): 593-594. doi: 10.3969/j.issn.1005-4561.2022.07.002 MENG X, WANG Z. WANG Zhen's experiences in treating cough variant asthma[J]. Zhejiang J Integr Tradit Chin West Med, 2022, 32(7): 593-594. doi: 10.3969/j.issn.1005-4561.2022.07.002
[6]	巢元方. 诸病源候论[M]. 北京: 人民卫生出版社, 1980: 105 CHAO Y F. Treatise on the pathogenesis and manifestations of all diseases[M]. Beijing: People's Medical Publishing House, 1980: 105.
[7]	徐铁有. 应用气机升降理论探析经方治疗"咳嗽上气"[J]. 中国中医急症, 2013, 22(12): 2072-2073. XU T Y. Applying the theory of gas machine lifting to explore the treatment of "cough and shangqi"[J]. J Emerg Tradit Chin Med, 2013, 22(12): 2072-2073.
[8]	李克光, 张家礼. 金匮要略译释[M]. 上海: 上海科学技术出版社, 2010: 121. LI K G, ZHANG J L. Translation interpretation of essentials from the golden cabinet[M]. Shanghai: Shanghai Scientific and Technical Publisher, 2010: 121.
[9]	关子赫, 刘建秋, 李敬孝. 《金匮要略》上气与"肺胀"的相关性探析[J]. 辽宁中医杂志, 2018, 45(7): 1378-1388. GUAN Z H, LIU J Q, LI J X. Relevance of shangqi and feizhang in Essentials from the Golden Cabinet[J]. Liaoning J Tradit Chin Med, 2018, 45(7): 1378-1388.
[10]	赵佶. 圣济总录[M]. 北京: 中国中医药出版社, 2018: 709. ZHAO J. Complete record of sacred benevolence[M]. Beijing: China Press of Traditional Chinese Medicine, 2018: 709.
[11]	广州中医学院. 内科讲义[M]. 广州: 广州中医学院, 1983: 42. Guangzhou College of Traditional Chinese Medicine. Lecture notes in internal medicine[M]. Guangzhou: Guangzhou College of Traditional Chinese Medicine, 1983: 42.
[12]	秦欢, 杨映梓, 施庆武, 等. 喘证发展源流考[J]. 中国中医基础医学杂志, 2023, 29(6): 875-878. QIN H, YANG Y Z, SHI Q W, et al. Textual research of asthma[J]. Chin J Bas Med Chin Med, 2023, 29(6): 875-878.
[13]	葛洪. 肘后备急方校注[M]. 北京: 中医古籍出版社, 2015: 112. GE H. Handbook of prescriptions for emergencies[M]. Beijing: Chinese Ancient Books Publishing House, 2015: 112.
[14]	王焘. 外台秘要[M]. 北京: 中国中医药出版社, 2011. WANG T. Complete record of sacred benevolence[M]. Beijing: China Press of Traditional Chinese Medicine, 2011.
[15]	姚雯, 严季澜. 哮病病名历史源流考[J]. 天津中医药, 2011, 28(1): 42-43. YAO W, YAN J L. Source and development of the titles of asthma[J]. Tianjin tradit Chin med, 2011, 28(1): 42-43.
[16]	杨颖, 王博寒, 巫善珩, 等. 哮病伏饮病机理论源流考述[J]. 中华中医药杂志, 2022, 37(7): 3765-3768. YANG Y, WANG B H, WU S H, et al. Origin and development of the theory of latent fuid retention pathogenesis of asthma[J]. China J Tradit Chin Med Pharm, 2022, 37(7): 3765-3768.
[17]	王新波, 王健, 张衍鲁, 等. 上气临床表现探析[J]. 中国中医基础医学杂志, 2019, 25(12): 1644-1645. WANG X B, WANG J, ZHANG Y L, et al. Analysis of the clinnical manifestations of abnormal rise of qi[J]. Chin J Basic Med Tradit Chin Med, 2019, 25(12): 1644-1645.
[18]	张仲景. 伤寒论[M]. 福州: 福建科学技术出版社, 2012. ZHANG Z J. Treatise on cold damage[M]. Fuzhou: Fujian Science and Technology Press, 2012.
[19]	王惟一, 王九思. 难经集注[M]. 北京: 中国医药科技出版社, 2018: 157. WANG W Y, WANG J S. Notes on canon of 81 difficult medical issues[M]. Beijing: China Medical Science and Technology Press, 2018: 157.
[20]	郭小舟, 林兰, 王斌. 奔豚病机和方证临证探讨[J]. 中医药学报, 2020, 48(4): 1-4. GUO X Z, LIN L, WANG B. Discussion on pathogenesis and clinical syndrome of bentun disease[J]. Acta Chin Med Pharmacol, 2020, 48(4): 1-4.
[21]	郑佐桓, 鞠宝兆, 董宝强, 等. 古病奔豚源流探析[J]. 辽宁中医杂志, 2020, 47(8): 60-64. ZHENG Z H, JU B Z, DONG B Q, et al. The mechanism of disease prescriptions and syndromes of running piglet[J]. Liaoning J Tradit Chin Med, 2020, 47(8): 60-64.
[22]	张岩, 于素平, 宋桂华, 等. 赵坤教授运用小青龙汤临证经验[J]. 亚太传统医药, 2020, 16(5): 77-79. ZHANG Y, YU S P, SONG G H, et al. Professor Zhao Kun's clinical experiences of Small Qinglong Decoction[J]. Asia-Pac Tradit Med, 2020, 16(5): 77-79.
[23]	江部洋一郎, 横田静夫, 徐文波. 经方医学[M]. 北京: 学苑出版社, 2011: 105. YOICHIRO E, SHIZUO Y, XU W B. Medical science of Jingfang[M]. Beijing: Xueyuan Press, 2011: 105.
[24]	张秉成. 成方便读[M]. 北京: 学苑出版社, 2010: 93. ZHANG B C. Into easy to read[M]. Beijing: Xueyuan Press, 2010: 93.
[25]	王桂彬, 庞博. 麦门冬汤方证探微[J]. 中医学报, 2022, 37(11): 2287-2290. WANG G B, PANG B. Prescriptions and syndromes of Maimendong Decoction[J]. Acta Chin Med, 2022, 37(11): 2287-2290.
[26]	魏荔彤. 金匮要略方论本义[M]. 北京: 人民卫生出版社, 1997: 108. WEI L T. Briefly discuss of the original meaning of essentials from the golden cabinet[M]. Beijing: People's Medical Publishing House, 1997: 108.
[27]	神农本草经[M]. 福州: 福建科学技术出版社, 2012. Shennong's classic of materia madica[M]. Fuzhou: Fujian science and technology press, 2012.
[28]	马梅芳, 李芳. 葶苈子本草与文献学考证[J]. 中医药通报, 2022, 21(7): 31-36. MA M F, LI F. Herbal textual and literature research of tinglizi[J]. Chin Med Bull, 2022, 21(7): 31-36.
[29]	李晶晶. 皂荚丸古今应用分析[J]. 环球中医药, 2021, 14(1): 57-59. LI J J. Analysis of the ancient and modern application of Zaojiawan[J]. Glob Tradit Chin Med, 2021, 14(1): 57-59.
[30]	DAI Y, CHAN Y P, CHU L M, et al. Antiallergic and anti-inflammatory properties of the ethanolic extract from Gleditsia sinensis[J]. Biol Pharm Bull, 2002, 25(9): 1179-1182.
[31]	张晓丹, 范春兰, 余迎梅, 等. 葶苈子水提液对CHF大鼠利尿作用的影响[J]. 中国现代应用药学, 2010, 27(3): 210-213. ZHANG X D, FAN C L, YU Y M, et al. Effect of tinglizi aqueous extract on diuretic effect in CHF rats[J]. Chin J Mod Appl Pharm, 2010, 27(3): 210-213.
[32]	傅阳, 袁培培, 侯颖, 等. 基于GnRHR信号通路探讨升浮药麻黄与沉降药葶苈子干预哮喘作用差异[J]. 中华中医药杂志, 2022, 37(5): 2553-2562. FU Y, YUAN P P, HOU Y, et al. Based on the GnRHR signaling pathway, the differences between ephedra and sedimentation drug Bulbophyllum diffusion in asthma were discussed[J]. China J Tradit Chin Med Pharm, 2022, 37(5): 2553-2562.
[33]	梁坤, 耿鑫, 刘艳芬. 五味子多糖调控PI3K/AKT/mTOR信号通路对哮喘小鼠气道重塑的影响[J]. 中国病理生理杂志, 2022, 38(7): 1210-1218. LIANG K, GENG X, LIU Y F. Effects of Schizandra polysaccharides regulating PI3K/AKT/mTOR signaling pathway on airway remodeling in asthmatic mice[J]. Chin J Pathophysiol, 2022, 38(7): 1210-1218.
[34]	叶冰, 却翎, 包·照日格图, 等. 干姜-细辛-五味子药对的止咳、抗炎作用研究[J]. 四川中医, 2010, 28(11): 61-62. YE B, QUE L, BAO Z R G T, et al. Study on cough and anti-inflammatory effects of dried ginger - spicy - schisandra[J]. J Sichuan Tradit Chin Med, 2010, 28(11): 61-62.