| 引用本文: |
赵留琴, 李沛鸿, 张毅堃, 胡鸿毅.基于“目中不了了”探讨从目诊辨治阳明急证[J].湖南中医药大学学报,2025,45(12):2391-2395[点击复制] |
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| 基于“目中不了了”探讨从目诊辨治阳明急证 |
| 赵留琴,李沛鸿,张毅堃,胡鸿毅 |
| (上海中医药大学附属龙华医院脾胃科, 上海 200032;上海市奉贤区中医医院, 上海 201400) |
| 摘要: |
| 阳明急证属于中医急症的重要范畴，本文从《伤寒论》“目中不了了”这一眼部体征出发，探讨目诊在阳明急证诊治中的意义。目睛体征可作为判断热邪炽盛、阴液将竭的重要指标。通过梳理阳明急证的经典条文与现代研究，结合临床病例，认为阳明急证病机为壮火弥漫、热炽津伤，或腑实壅塞、升降逆乱。基于病机演变，提出清经泻热、益胃生津，通腑化滞、泻火存阴的治则治法。目诊可弥补传统辨证诊断体系的不足，为早期干预阳明急证提供客观依据。本文旨在丰富阳明急证的诊断思路，强调中医“见微知著”的诊断特色在中医急症中的应用价值。 |
| 关键词: 目诊 目中不了了 急下存阴 阳明急证 《伤寒论》 辨证诊断体系 |
| DOI：10.3969/j.issn.1674-070X.2025.12.021 |
| 投稿时间：2025-08-27 |
| 基金项目:中国中医科学院科技创新工程项目（CI2023C020LH）。 |
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| Diagnosis and treatment of Yangming acute patterns through eye diagnosis based on the sign of "mu zhong bu liao liao" |
| ZHAO Liuqin, LI Peihong, ZHANG Yikun, HU Hongyi |
| (Department of Gastroenterology, Longhua Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;Shanghai Fengxian District Traditional Chinese Medicine Hospital, Shanghai 201400, China) |
| Abstract: |
| Yangming acute patterns fall within the significant scope of emergency cases in TCM. By focusing on the eye sign "mu zhong bu liao liao" (blurred vision with impaired eye responsiveness) described in the Shang Han Lun (Treatise on Cold Damage), this paper explores the significance of eye diagnosis in the diagnosis and treatment of Yangming acute patterns. The signs of eyes serve as sensitive indicators for assessing pathogenic heat exuberance and impending yin fluid exhaustion. By reviewing classical texts and modern research on Yangming acute patterns, and integrating clinical cases, the pathogenesis is considered to involve either exuberant fire pervading throughout the body with body fluids depleted by scorching heat or fullness-induced obstruction in fu-organs, with disturbed qi ascending and descending. Based on the evolution of pathogenesis, the therapeutic principles and methods of clearing the meridians to purge heat, benefiting the stomach to generate fluids, unblocking the fu-organs to eliminate stagnation, and clearing fire to preserve yin are proposed. Eye diagnosis complements the limitations of traditional pattern differentiation and diagnosis systems, and provides an objective basis for early intervention in Yangming acute patterns. This paper aims to enrich diagnostic approaches for Yangming acute patterns, emphasizing the value of TCM diagnostic principle of "detecting subtle signs to predict significant changes" in TCM emergency cases. |
| Key words: eye diagnosis mu zhong bu liao liao urgent purgation to preserve yin Yangming acute patterns Shang Han Lun (Treatise on Cold Damage) pattern differentiation and diagnosis system |
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