张仲景基于气宜的辨病论治思想解析OA
Analysis of ZHANG Zhongjing's thought of treatment based on disease differentiation rooted in qi suitability
为了阐明张仲景基于气宜的辨病论治思想,本文以《黄帝内经》《伤寒论》《金匮要略》的论述为主要依据,深度解析了气宜与病机、治法的密切关系.研究表明,以张仲景为代表的早期医家,他们在初创学术体系之时,便已援哲入医,形成了从气宜到病机再到治法的系列认识.气宜是气的规律性变化,具体包括气机开阖与气立消长.一旦人体的阖长开消超出常度,就会带来病机的郁盛泄衰,呈现为各种各样的症状.为了引导病机的变化,中医的治法灵活应用了药物的属性.例如,药味的辛散、酸收、苦急、甘缓,恰好构成了序贯式的气宜制衡关系.在逆微从甚的原则指导下,它们或通或平,可以帮助人体恢复到阴阳自和的状态.由此可知,张仲景的辨病论治思想朴素而深邃,是经方治疗体系的科学内核,对于当代中医的发展仍然有着重要的学术价值.
To elucidate ZHANG Zhongjing's thought of treatment based on disease differentiation rooted in qi suitability,this paper primarily draws on the discussions in Inner Canon of Yellow Emperor,Treatise on Cold Pathogenic Diseases,and Synopsis of Golden Chamber to analyze the close relationship between qi suitability,pathogenesis,and treatment method.Early Chinese medicine pioneers,represented by ZHANG Zhongjing,integrated philosophical concepts into medicine at the inception of their academic systems,thereby developing a coherent framework from qi suitability to pathogenesis and further to treatment method.Qi suitability refers to regular qi changes,including the opening and closing of qi movement and the waxing and waning of qi establishment.Once the opening,closing,increase,and decrease of the bodily qi deviate from the normal range,it leads to stagnation,excess,leakage,and decline in pathogenesis,manifesting as various symptoms.To guide the transformation of pathogenesis,the therapeutic method in traditional Chinese medicine applies the properties of medicinal substances.For example,the pungent divergent,sour astringent,bitter stimulating,and sweet soothing effects of medicinal flavors constitute a sequential balance relationship of qi suitability.Guided by the principle of orthodox treatment for mild or slow conditions and retrograde treatment for severe or urgent conditions,these flavors either restore patency or balance,thereby helping the body return to a state of natural harmony of yin-yang.Thus,ZHANG Zhongjing's thought on disease differentiation and treatment is both simple and profound,serving as the scientific core of the classical formula treatment system and retaining significant academic value for the development of contemporary Chinese medicine.
陈萌
北京中医药大学中医学院 北京 100029
医药卫生
张仲景气宜辨病论治病机治法
ZHANG Zhongjingqi suitabilitytreatment based on disease differentiationpathogenesistreatment method
《北京中医药大学学报》 2026 (7)
915-921,7
国家自然科学基金项目(No.82474382) National Natural Science Foundation of China(No.82474382)
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