基于“标本从化”理论的三因司天方临证举隅

Clinical case studies of Sanyin Sitian Formulas application based on the theory of Biaoben Conghua (conformity of the root and superficies)

摘要

“标本从化”揭示了六气于气化“之变”时的从化方向，且明确六气中以寒、火、热、湿四者为主体性气化属性。这一认识为运气临证常见的气化要素错综复杂甚或相左之情况提供诊疗启示：应认识到气化既有六气常态“之化”，亦可有气化“之变”，变可从“本”而始终为本气特征，从“中”而为它气，如胜复之气，从“本标”而本气叠加它气。故运气临证分析时不当拘泥于主令之气化，而应四诊合参，重视患者主症及舌脉反映的气化倾向，分辨病机系其气化格局之常，亦或气化“之变”所致看似错综、实则有迹可循之征，从而拟定运气治疗。并结合临床验案对基于“标本从化”理论的三因司天方临证经验进行阐释。

Abstract

The theory of Biaoben Conghua (transformation of the root and branch) elucidates the direction of conformity of the Six Qi during changes in qi transformation. It clearly identifies cold, fire, heat, and dampness as the dominant qi transformation attributes among the Six Qi. This understanding provides diagnostic and therapeutic insights for complex or seemingly contradictory manifestations of qi transformation elements commonly encountered in clinical practice guided by Yunqi theory. It emphasizes that qi transformation encompasses both the normative zhihua (transformation) of the Six Qi and potential zhibian (changes). These changes can manifest as conformity to the ben (root, maintaining the characteristic of the original qi), conformity to the zhong (middle, transforming into another qi, such as retaliatory qi), or conformity to biaoben (superficies and root, combining the original qi with another). Therefore, Circuit-Qi clinical analysis should not rigidly adhere to the transforming qi of the ruling season. Instead, it necessitates comprehensive diagnosis using the four examinations, prioritizing the patient's chief complaint and the qi transformation tendencies reflected in the tongue and pulse. This allows differentiation between disease mechanisms stemming from the normative qi transformation pattern and those arising from zhibian in qi transformation, which present seemingly intricate yet traceable signs. Treatment strategies based on Circuit and Qi principles can then be formulated. This article illustrates clinical application of Sanyin Sitian Formulas based on biaoben conghua through validated case studies.

关键词

五运六气 / 标本中气 / 标本从化 / 三因司天方 / 附子山萸汤 / 备化汤

Key words

Five Circuits and Six Qi / biao, ben, and zhong qi / conformity of the root and superficies / Sanyin Sitian Formulas / Fuzi Shanyu Decoction / Beihua Decoction

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基金资助

国家社会科学基金重大项目(21&ZD349)