六经辨证是张仲景在《伤寒论》中创立的辨证论治方法,至今仍有效指导着临床实践.六经辨证不独为外感病而设,亦可指导杂病的辨证治疗.本文通过系统梳理《伤寒论》《金匮要略》有关呕吐的条文,浅要探析了张仲景对呕吐病名的认识,在六经辨治方面提出,太阳病呕吐宜解表宣通降逆、解表和营降逆、解表化饮止呕、温阳利水止呕;阳明病呕吐宜清热通腑降逆、清热补虚降逆、清热养血降逆、清热滋阴降逆;少阳病呕吐宜疏肝清热降逆、疏肝和营降逆、疏肝和胃降逆;太阴病呕吐宜温中化饮止呕、温胃散寒止呕;少阴病呕吐宜温阳散寒降逆、温胃蠲饮降逆、温阳利水降逆;厥阴病呕吐宜温中和胃降逆、温中清热降逆.本文结合现代学者临床应用情况,阐述了六经辨治呕吐的中医理法方药,为中医医师临床从整体出发,坚持六经辨治原则,提高呕吐临床治疗疗效拓宽诊疗思路.
The Six Classics Syndrome Differentiation is a syndrome differentiation and treatment method established by ZHANG Zhongjing in his book"Treatise on Cold Damage",which still effectively guides clinical practice to this day.The six meridians differ-entiation is not only designed for external diseases,but also guide the differentiation and treatment of miscellaneous diseases.This ar-ticle systematically reviews the articles related to vomiting in"Treatise on Cold Damage"and"Synopsis of the Golden Chamber",and briefly analyzes ZHANG Zhongjing's understanding of the name of vomiting disease.In terms of the differentiation and treatment of the six meridians,it proposes that vomiting in Taiyang disease should be treated by clearing the exterior,promoting circulation and lowering the reverse,clearing the exterior and reducing the reverse,clearing the exterior and transforming the drink to stop vomiting,and warming yang,promoting diuresis,and stopping vomiting;Yangming disease vomiting should be treated with methods such as clearing heat,tonifying the internal organs,lowering adverse reactions,clearing heat,nourishing blood,clearing heat,nourishing yin,and lowering adverse reactions;Shaoyang disease vomiting should be treated with methods such as soothing the liver,clearing heat,re-ducing adverse reactions,soothing the liver and reducing adverse reactions,and soothing the liver and stomach;For vomiting caused by Taiyin disease,it is recommended to warm the middle and dissolve the drink to stop vomiting,and warm the stomach to dispel cold and stop vomiting;Vomiting due to Shaoyin disease should be treated with warming yang and dispersing cold to lower the adverse effects,warming stomach and promoting diuresis to lower the adverse effects,and warming yang and promoting diuresis to lower the adverse effects;Vomiting due to Jueyin disease should be treated with warmth to neutralize the stomach and lower the reflux,as well as warmth to clear heat and lower the reflux.Combined with the clinical application of modern scholars,this article elaborates on the traditional Chinese medicine principles and prescriptions for treating vomiting based on the differentiation of the six meridians,provi-ding a holistic approach for traditional Chinese medicine practitioners in clinical practice,adhering to the principle of differentiation of the six meridians,and improving the clinical treatment efficacy of vomiting,broadening their diagnostic and therapeutic ideas.