【作者】 孙海燕；

【导师】 连建伟；

【作者基本信息】 浙江中医药大学 ， 中医临床基础， 2014， 博士

【摘要】 目的通过对仲景《金匮要略》论湿之病脉证治的研究,从病、脉、证、治的角度探讨仲景论湿的规律,归纳仲景论湿的特点,从而助益临床湿病的辨治。同时,以期由湿为切入口,增加对仲景理论的研究角度和研究方法,为其他病因病邪致病的病脉证治研究奠定基础。方法从概念入手明确“湿”、“湿气”、“湿邪”、“湿病”等的含义,进而分篇分条缕析《金匮要略》中与湿有关的篇章和条文,并从病、脉、证、治的角度分别进行分析,找出各自的规律,最后在此基础上体会并归纳总结原著论湿的特点。结果①《金匮要略》论湿之病,重视湿病的诊断与鉴别、判断湿病的转归与预后、注意湿病的转化与演变。②《金匮要略》论湿之脉,较舌详细,有主脉、可见脉、相兼脉、成因脉、补充脉。③《金匮要略》论湿之证,通过识症以辨病,而辨证以辨病为前提,辨同病之异证、兼证及坏证,并对兼症、或然症进行随症加减。④《金匮要略》论湿之治,内治法和外治法灵活丰富,从“汗”、“便”见治效,由“二禁一慎”明治禁。⑤《金匮要略》论湿的特点,辨病证症结合论治、谨守脏腑经络辨证、创湿病治法与方剂。结论《金匮要略》论湿并不囿于湿痹,论湿之病脉证治着实有助临床,实开湿病体系之先河。追随仲景思维,论湿之病脉证治,为其他病因病邪致病的病脉证治研究奠定基础。更多还原

【Abstract】 Objective Discuss the rule and feature about dampness in Jin Kui Yao Lve written by Zhang Zhongjing, from the aspects of diseases, pulses, symptoms, syndromes and treatments, in order to benefit the diagnosis and treatment in clinical diseases caused by dampness. As an entry point, increase views of research and study methods about Zhang Zhongjing’s theory and lay the foundation of research on other pathogenesis and pathogenic factors in the same way.Methods Clear and definite the concepts about dampness, dampness-qi, evil dampness, diseases caused by dampness, etc.. Then sort out chapters, sections and items about dampness in Jin Kui Yao Lve, analyze and find out the rule respectively from the aspects of diseases, pulses, symptoms, syndromes and treatments. On this basis, understand and summarize the feature about dampness in the original.Results①When Jin Kui Yao Lve discusses diseases caused by dampness, it pays attention to diagnosis and differential diagnosis, estimates clinical outcome and prognosis, notices conversion and evolution in diseases as well.②When Jin Kui Yao Lve discusses pulses about dampness, it describes the pulses more than the tongues, including main pulses, visible pulses, subordinate pulses, etiogenic pulses and supplement pulses in detail.③When Jin Kui Yao Lve discusses symptoms and syndromes, it differentiates diseases by recognizing the symptoms, then differentiates syndromes, including different syndromes, subordinate syndromes and bad syndromes, and add or subtract the herb according subordinate symptoms and probable symptoms.④When Jin Kui Yao Lve discusses treatments, its internal therapy and external therapy are flexible and plentiful, including cure changes in sweat, excrement or urine and therapy prohibitions.⑤Jin Kui Yao Lve combines diseases, syptoms and syndromes together for diagnosis and treatment, takes syndrome differentiation of viscera and meridians as law and creates therapeutic methods and prescriptions for diseases caused by dampness.Conclusion Dampness discussed in Jin Kui Yao Lve is not limited by dampness-obstruction, but creates a precedent in the system of diseases caused by dampness. Following the thought of Zhang Zhongjing, study diseases, pulses, symptoms, syndromes and treatments about dampness, as well as lay the foundation of research on other pathogenesis and pathogenic factors in the same way.更多还原