五苓散證非關太陽膀胱蓄水

Wu Ling San Syndrome is Not Associated with Stagnated Fluid in Bladder

賴宛鍾(Wan-Chung Lai)

《中醫藥研究論叢》 9卷1期 (2006/03) Pp. 144-156

https://doi.org/10.6516/TJTCM.200603_9(1).0014

摘要

五苓散證之病證並非嚴重危證，但其真正的病因病機卻常為人所忽略，前賢的說法“太陽膀胱蓄水”或“膀胱蓄水”之觀點似是而非，無法滿足臨床上運用五苓散之時機。筆者運用仲景條文，以經解經的方式，兼參考歷代醫家對五苓散之論述，發現五苓散之病機應該是脾胃停飲，脾胃無法運化水濕，致三焦氣機不利，上則口渴，下則小便不利。提出對五苓散證全新的看法，說明五苓散證不能從太陽經脈、膀胱腑病的角度來加以詮釋，而應是中焦脾胃水氣之運化失調，所產生的病證。以期能更明確了解五苓散真正病機，讓臨床上更能準確掌握運用的時機。

關鍵字

五苓散 ； 傷寒論 ； 脾胃停飲

並列摘要

Wu Ling San syndrome is not a dangerous syndrome, but its real pathogenesis is often neglected by people. The viewpoint of ”stagnated fluid in bladder” is not real. The application of Wu Ling San can not satisfy it clinically. The author uses Zhongjing Article to find out that the mechanism of Wu Ling San is associated with spleen and stomach, where the dampness can't be dispelled due to dysfunction of stomach and spleen, so the inhibition of the qi mechanism in sanjiao is occurred to get thirst, and dysuria. New explanation of Wu Ling San is propose, to describe that Wu Ling San syndrome can not be described from Urinary Bladder Meridian of Taiyang. It is the disorder caused by loss of regulation of the stomach & spleen in middle jiao. The mechanism of Wu Ling San can be understood well to grasp the application time for clinical treatment precisely.

並列關鍵字

Wu Ling San ； Treatise on Typhoid Fever ； edema due to dysfunction of stomach and spleen