基于“一气周流”理论解读小建中汤

刘硕 王一楠 阳缘乐 杨志军 杨秀娟 张金保 邵晶 梁永林

【摘要】“一气周流”理论是黄元御学术思想的高度概括，小建中汤是张仲景创立的经方，黄元御《伤寒说意》中将小建中汤证列为少阳入腑证。文章阐述了“一气周流”理论概况，提出表里周流的关系，从“一气周流”角度分析小建中汤证的病机乃中气衰弱，木气失常，表之营卫周流与里之脏腑周流均失和，从药味组成上分析小建中汤具有通经调营卫达表之“一气周流”，泄木安土顺里之“一气周流”的作用。并列举分析小建中汤治疗消化性溃疡、心悸与黄疸的应用，展示了经方中蕴含的“一气周流”思想，以全新的角度理解小建中汤的病机与功效，开拓临床应用思路。

【关键词】一气周流；小建中汤；营卫；泄土安木

【中图分类号】R229【文献标志码】 A【文章编号】1007-8517（2023）10-0019-04

Interpretation of Xiao Jian Zhong Decoction Syndrome based on the Theory of “One Qi Circulation”LIU ShuoWANG YinanYANG YuanleYANG Zhijun*YANG XiujuanZHANG JinbaoSHAO JingLIANG  Yonglin

Gansu University of Traditional Chinese Medicine，Lanzhou 730000，ChinaAbstract：The theory of “one qi circulation” is a high generalization of Huang Yuanyus academic thought， and Xiao Jian Zhong Tang is a classic prescription created by Zhang Zhongjing . Huang Yuanyu classified the syndrome of Xiaojianzhong decoction as the syndrome of Shaoyang viscera in the Interpretation of treatise on Febrile Diseases.This paper first expounds the general situation of the theory of “one qi circulation” and puts forward the relationship between the exterior and interior circulation，Then from the perspective of “one qi circulation”， the author analyzes that the pathogenesis of Xiao jian zhong decoction is the weakness of the middle Qi， the disorder of wood Qi， and the disharmony of the Ying and Wei circulation on the surface and the viscera circulation in the interior. From the composition of the medicine， it is analyzed that Xiao jian zhong decoction can open main and collateral channels， adjust the Ying and Wei to normalizethe the surfce of “one qi circulation”， and release the qi of wood and settle the qi of tu smoothly. Finally， the application of Xiaojianzhong Decoction in the treatment of peptic ulcer， jaundice and palpitation is enumerated and analyzed， which shows the idea of “one qi circulation” contained in the classic prescription.Understand the pathogenesis and efficacy of Xiaojianzhong decoction from a new perspective， and explore the application ideas of clinicians.

Keywords：One Qi Circulation;Xiao Jian Zhong Decoction;Ying and Wei ;Elease the Qi of Wood and Settle the Qi of Tu Smoothly

黃元御为清代著名医学家，医术精湛得乾隆喜爱，理论独树一帜，世人研读其著作，悟其理论精髓，概括出“一气周流”思想。黄元御考镜灵兰，讵读伤寒，自述凡一言不解遍览群家之言，搜尽笺注，呕心沥血解读仲景之法，使一气的周流气化浮现于六经气化之中，故“一气周流”实则与仲景之法一脉相承［1］。小建中汤为仲景所创，临床上多用于中焦虚寒类疾病，今笔者从“一气周流”角度重新探析小建中汤立意。

1“一气周流”

1.1“一气周流”理论概况 黄元御尊崇经典，精通阴阳五行理论，运气学说，得《黄帝内经》《难经》《伤寒论》《金匮要略》“四圣”之心法，留下传世名著十一部，以《四圣心源》为代表性著作，后世之人从中概括出“一气周流”的理论脉络。……