中医结证理论体系构建与内涵阐释OA
Construction and interpretation of the theoretical system of binding syndrome in traditional Chinese medicine
"结"是中医认识复杂病证发生、发展与转归的重要病机范畴.本文以《黄帝内经》《伤寒杂病论》及后世医家结胸、癥瘕、积聚、瘿瘤、痰核、痰瘀互结、久病入络等论述为依据,通过文献归纳、概念辨析与理论整合,梳理"结"由字义、病机、病证至治法的发展脉络,明确结证作为动态复合病机模型的理论内涵与临床边界,对结证的发生基础、演化环节和辨治取向进行重构.结证可概括为一种邪气由散而聚、由动而止,阻滞气血津液运行,并逐渐形成气结、痰结、瘀结、虚结交织的动态病理过程.其脏腑基础以肝失疏泄为气结之始,脾失健运为痰结之源,血行失畅为瘀结之枢,肾精亏虚与正气不足为虚结之本;其形态可分为无形之结与有形之结,病位可及脏腑、经络、形体、官窍.结证理论有助于贯通功能失调、病理产物生成、有形病灶形成及久病正虚难复等环节,可为复杂病证的分期辨识、病性判断及散结通滞治疗提供理论依据.
Binding syndrome is a crucial pathogenesis category in traditional Chinese medicine for understanding the occurrence,development,and outcome of complex diseases.Based on discussions in Huangdi Neijing,Shanghan Zabing Lun,and later medical practitioners on chest binding,zhengjia,abdominal mass,goiter and tumors,phlegm nodules,phlegm-stasis binding,and chronic disease invading the collaterals,this study adopts literature induction,conceptual analysis,and theoretical integration to trace the developmental trajectory of"binding"from its lexical meaning to pathogenesis,disease patterns,and therapeutic methods.It clarifies the theoretical connotation and clinical boundaries of binding syndrome as a dynamic and complex pathogenesis model,and reconstructs its occurrence basis,evolutionary links,and principles of syndrome differentiation and treatment.Binding syndrome is summarized as a dynamic pathological process in which pathogenic factors aggregate from a dispersed state and become fixed from a mobile state,thereby obstructing the movement of qi,blood,and body fluids,and gradually forming an interwoven state of qi binding,phlegm binding,stasis binding,and deficiency binding.In terms of zang-fu pathogenesis,liver failing to convey and disperse marks the beginning of qi binding,impaired spleen transportation and transformation provides the source of phlegm binding,unsmooth blood circulation serves as the pivot of stasis binding,and kidney essence deficiency with insufficiency of healthy qi constitutes the root of deficiency binding.Morphologically,binding syndrome can be classified into invisible binding and visible binding,with disease locations involving the zang-fu organs,meridians and collaterals,body,and orifices.The theory of binding syndrome helps to integrate functional disorder,the generation of pathological products,the formation of visible lesions,and prolonged disease with difficult recovery owing to healthy qi deficiency.It provides a theoretical basis for staged identification,judgment of disease nature,and therapeutic strategies aimed at dispersing binding and removing stagnation in complex disorders.
许文娟;杨文明;方淑珍;杨玉龙;徐扣
安徽中医药大学第一附属医院 合肥 230031安徽中医药大学第一附属医院 合肥 230031||安徽中医药大学脑病研究院||合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所||新安医学教育部重点实验室安徽中医药大学第一附属医院 合肥 230031安徽中医药大学第一附属医院 合肥 230031安徽中医药大学第一附属医院 合肥 230031
医药卫生
结证结者散之气结痰结瘀结虚结癥瘕积聚
binding syndromedispersing bindingqi bindingphlegm bindingstasis bindingdeficiency bindingzhengjia and abdominal mass
《北京中医药大学学报》 2026 (8)
1086-1093,8
四大慢病重大专项(No.2023ZD0505801)安徽省中医药科技攻关专项项目(No.202303a07020004)新安医学与中医药现代化研究所"揭榜挂帅"项目(No.2024CXMMTCM001)新安医学脑病领军人才团队项目(皖教秘人[2021]108号) Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0505801)
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