《伤寒杂病论》与《中医内科学》互参探讨黄疸的分型辨治

通过分析互参《伤寒杂病论》和《中医内科学》中黄疸的辨治内容,总结出广义黄疸的病因主要有感受外邪、失治误治、内伤酒食、房劳虚劳;病机以湿邪为主导,涉及疫毒、表邪、湿热、寒湿、虚寒、瘀血、水饮等;临床分型包括湿热疫毒炽盛证(急黄)、湿热内蕴、湿热壅上、寒湿困脾、少阳胆腑郁热、血瘀发黄、表郁发黄、房劳伤肾、水热互结、脾胃虚弱、肝脾不调,共计11个证型,相应治疗方法有清热解毒、清热利湿、涌吐开壅、温中化湿、和解少阳、活血祛瘀、解表祛湿、宣肺利水、温补中焦、调和肝脾。

Differentiation and Treatment of Jaundice with Reference to Treatise on Cold Pathogenic and Miscellaneous Diseases and Internal Medicine of Traditional Chinese Medicine

By analyzing the contents of the differentiation and treatment of jaundice with reference to Treatise on Cold Pathogenic and miscellaneous Diseases and Internal Medicine of Traditional Chinese Medicine,it is concluded that the causes of generalized jaundice mainly include external contraction,mistreatment,internal damage,sexual strain and deficiency-consumption. The pathogenesis is dominated by pathogenic dampness,involving epidemic toxin,exopathogens,damp-heat,cold-damp,deficient cold,blood stasis,fluid retention,etc. The clinical classification includes a total of 11 syndromes:intense damp-heat and epidemic toxin syndrome(acute jaundice),internal accumulation of damp-heat syndrome,damp-heat accumulating upward syndrome,cold-dampness encumbering the spleen syndrome,pathogenic factors in shaoyang syndrome,constraint-heat in the gallbladder syndrome,blood stasis jaundice syndrome,exterior constraint jaundice syndrome,sexual strain damaging kidney syndrome,binding of water and heat syndrome,deficiency of spleen and stomach syndrome,liver-spleen disharmony syndrome. The treatment principles include:heat-clearing and detoxifying,clearing away heat and dampness,vomiting and resolving congestion,warming the center and removing dampness,harmonizing shaoyang,invigorating blood and dissolving stasis,releasing exterior and removing dampness,diffusing the lung and promoting urination,warming the middle energizer and regulating the liver and spleen.