"胆-肠轴"假说:小柴胡汤证病机理论新探OACHSSCD

This study systematically reviews the relevant passages on Xiaochaihu Decoction syndromes in the Treatise on Febrile Diseases and proposes a new interpretation of the traditional pathogenesis of Xiaochaihu Decoction syndromes by integrating the ac-ademic debates among physicians of past dynasties and recent research advances.Through textual analysis combined with modern anatomical knowledge and logical deduction,the study finds that the essence of core symptoms such as"chest and hypochondriac fullness and discomfort"and"alternating chills and fever"is intestinal qi stagnation caused by dysfunction of the gallbladder's dredging and discharging function,rather than merely a vague spatial concept of simultaneous exterior and interior disease.The syn-drome differentiation logic of"diagnosis based on the presence of one key symptom"should follow a ternary model of"core patho-genesis-main symptom group-dynamic syndrome differentiation",the essence of which is to identify the key nodes of dysfunction of the gallbladder-intestine pivot.The disputes among physicians of past dynasties over"half-exterior and half-interior"stem from confusion between the state of pathogenesis and anatomical location,whereas the primary disease location of Xiaochaihu Decoction syndromes is actually"under the hypochondrium",and its dynamic evolution conforms to the pathological characteristics of dys-functional coordination of the"gallbladder-intestine axis".By reinterpreting the classical passages in combination with modern a-natomy,this study reveals the pathogenesis chain of"gallbladder stagnation-intestinal obstruction"in Xiaochaihu Decoction syn-dromes,providing a basis for the clinical application and theoretical innovation of classical prescriptions.