从脉象探讨《难经》“阴阳盛虚汗下法”及其临床应用

Discuss “the method of yin and yang excessiveness or deficiency with sweat or diarrhea” in Nanjing and its clinical application from the pulse condition

关键词:  《难经》  阴阳盛虚  阴阳脉象  汗下法  气机出入

Key words:  Nanjing  yin and yang excessiveness or deficiency  pulse condition of yin and yang  the method of sweat or diarrhea  qi activity in and out

摘要:

“阴阳盛虚汗下法”始见于《难经·五十八难》，“阳虚阴盛，汗出而愈，下之即死；阳盛阴虚，汗出而死，下之而愈”，后世医家对此理解执见不一。两者皆为外感疾病中的危重病证，文章提及从脉象把握“阴阳盛虚汗下法”更易于诊断和指导临床治疗。即阳虚阴盛脉见浮取小弱或难以触及，沉取应指明显或推筋至骨方得，此时阴寒凝盛而阳虚不能透达，人体气机入多出少，治当温阳发汗，使阳气得助，阴邪得散，如麻黄细辛附子汤之类；阳盛阴虚脉见浮取应指明显，沉取柔弱或难以动指，此时阳热炽盛而阴津竭乏，人体气机出多入少，治当滋阴攻下，折其阳热，急保阴津，如增液承气汤之类。

Abstract:

“The method of yin and yang excessiveness or deficiency with sweat or diarrhea” begins in Nanjing:Fifty-eight Difficult, "yang deficiency yin excessiveness, sweat out and more, diarrhea the death;yang excessiveness yin deficiency, sweat out and die, diarrhea the more", later generations of doctors have different understanding of this. Both of them are critical illness symptoms of external diseases, the author thinks that it is easier to diagnose and guide the clinical treatment by grasping "the method of yin and yang excessiveness or deficiency with sweat or diarrhea" from the pulse condition. That is the pulse condition of yang deficiency yin excessiveness is float take small weak or difficult to touch, sink should refer to obvious or push tendons to bone square, at this time yin cold condensation excess and yang deficiency cannot be permeable, the qi goes into more and less, when help yang and sweat, to help yang qi, with yin evil scattered, such as Mahuang Xixin Fuzi Decoction;the pulse condition of yang excessiveness yin deficiency is float should refer to obvious, sink to take weak or difficult to move the finger, at this time yang hot strong and yin jin exhausted, the qi comes out more into less, when the treatment of yin attack, to eliminate its yang heat, and save urgent yin jin, such as Zengye Chengqi Decoction.