[1]程舒婷,冯刚,马丙祥.基于“卫气耗伤梯度”论太阳病误下变证[J].陕西中医,2026,(2):218-222.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.013]
　CHENG Shuting,FENG Gang,MA Bingxiang.Pathomechanism of Taiyang disease misused purgation based on gradient of Weiqi consumption and injury[J].,2026,(2):218-222.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.013]
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基于“卫气耗伤梯度”论太阳病误下变证

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年2期
页码:
218-222
栏目:
学术探讨
出版日期:
2026-02-05

文章信息/Info

Title:
Pathomechanism of Taiyang disease misused purgation based on gradient of Weiqi consumption and injury
作者:
程舒婷1; 冯刚2; 马丙祥2
（1.河南中医药大学儿科医学院，河南 郑州 450046；2.河南中医药大学第一附属医院儿科医院，河南 郑州 450099）
Author(s):
CHENG Shuting1; FENG Gang2; MA Bingxiang2
(1.College of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China；2.Pediatric Hospital,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China)
关键词:
太阳病误下; 卫气耗伤梯度; 动态病机; 分层辨治; 脾胃-卫气轴; 经方配伍
Keywords:
Taiyang disease misused purgation; Gradient of Weiqi consumption and injury; Dynamic pathogenesis; Stratified treatment; Spleen-stomach-Weiqi axis; Classical formula compatibility
分类号:
R 22
DOI:
DOI:10.3969/j.issn.1000-7369.2026.02.013
文献标志码:
A
摘要:
基于《内经》卫气理论，创新构建“卫气耗伤梯度”理论模型，系统阐释《伤寒论》太阳病误下后的演变规律，揭示误下致逆的病理传变机制，为仲景“保胃气”思想提供依据，推动卫气理论向临床实证转化。以《内经》“卫气温分肉、充皮肤、肥腠理”为基础，提出“卫气耗伤梯度”模型，系统研究《伤寒论》35条太阳病误下变证，将气机紊乱类型界定为气逆、气滞与气衰，并统计其占比，结合《伤寒论》《灵枢》等经典，分析误下后“卫气代偿上冲-中焦升降紊乱-温煦功能衰竭”的阶段性病机，建立“脾胃-卫气轴”动态模型，分层归纳辨治方案（卫强证、卫损证、卫竭证）。通过分析《伤寒论》35条太阳病误下变证，发现气机紊乱占比 88.57%。太阳病误下演变遵循“气逆-气滞-气衰”三阶规律：初下伤卫之桂枝汤证，卫气代偿上冲；再下损中之栀子豉汤、泻心汤证，气滞痞结；三下竭源之真武汤证，卫虚失用。临床分层辨治方案：卫强证调和营卫之桂枝汤类，卫损证斡旋中焦之泻心汤类，卫竭证温培少火之真武汤类。本研究通过量化分析支持仲景“保胃气”思想，证实卫气耗伤梯度与误下变证严重程度呈正相关，为卫气理论临床转化提供新范式。
Abstract:
Based on the theory of Weiqi in the Huangdi Neijing,a new theoretical model of Weiqi consumption gradient was innovatively constructed to systematically explain the evolution rules of Taiyang syndrome after improper purgation in the Shanghan Lun,revealing the pathological transmission mechanism of improper purgation leading to adverse conditions.This provides evidence for Zhang Zhongjing’s idea of preserving the stomach Qi and promotes the transformation of the Weiqi theory into clinical practice.Based on the Huangdi Neijing statement that Weiqi warms the flesh,fills the skin,and fattens the pores,the Weiqi consumption gradient model was proposed.A systematic study was conducted on the 35 cases of Taiyang syndrome after improper purgation in the Shanghan Lun.The types of Qi disorders were defined as Qi rebellion,Qi stagnation,and Qi exhaustion,and their proportions were statistically analyzed.Combined with classics such as the Shanghan Lun and Ling Shu,the staged pathogenesis of Weiqi compensatory upward surge-disorder of the middle jiao ascending and descending-failure of warming function after improper purgation was analyzed.A dynamic model of the spleen and Stomach-Weiqi axis was established,and the treatment plans were classified and summarized (Weiqi strong syndrome,Weiqi damaged syndrome,Weiqi exhausted syndrome).Through the analysis of the 35 cases of Taiyang syndrome after improper purgation in the Shanghan Lun,it was found that the proportion of Qi disorders was 88.57%.The evolution of Taiyang syndrome after improper purgation follows a three-stage rule of Qi rebellion-Qi stagnation-Qi exhaustion:the first improper purgation damages Weiqi,resulting in the compensatory upward surge of Weiqi;the second improper purgation damages the middle jiao,leading to Qi stagnation and fullness;the third improper purgation exhausts the source,resulting in Weiqi deficiency and loss of function.The clinical stratified treatment plans are:for Weiqi strong syndrome,use the Guizhi decoction to harmonize Ying and Wei;for Weiqi damaged syndrome,use the Zhizi Da Huang decoction to regulate Zhongjiao;for Weiqi exhausted syndrome,use the Zhenwu decoction to warm and nourish Shenyang.This study supports Zhang Zhongjing’s idea of preserving the stomach Qi through quantitative analysis,confirming that the Weiqi consumption gradient was positively correlated with the severity of improper purgation-induced changes,providing a new paradigm for the clinical transformation of the Weiqi theory.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82474569）
更新日期/Last Update: 2026-02-09