『備急千金要方』 臟腑溫病의 기전과 치법에 대한 考察 (A Study on the Mechanism and Treatment of the Zang-fu Warm Disease in the BeijiQianjinYaofang)

서지정보

· 발행기관 : 대한한의학원전학회
· 수록지 정보 : 대한한의학원전학회지 / 37권 / 2호 / 49 ~ 76페이지
· 저자명 : 안진희

초록

Objectives : 이 논문의 목적은 『備急千金要方』 臟腑溫病의 기전과 치법을 고찰하는 것이다.
Methods : 『備急千金要方』, 『傷寒總病論』, 『三因方』 臟腑溫病을 대상으로 하여 『內經』에 근거한 기전 설명 및 세 책간의 공통점과 차이점을 중심으로 治法의 내용을 분석하였다.
Results and Conclusions : 1. 臟腑溫病은 계절에 맞지 않는 不正之氣에 의해 일어나고, 전염성, 유행성, 계절성을 지니는 疫病이다. 2. 靑筋牽病은 少陰과 少陽의 관계성으로 설명되었으나, 실제 병증은 太陽經쪽에 많이, 少陽經쪽에 일부분 나타났다. 腑虛證의 치법에 『千金要方』과 『傷寒總病論』은 柴胡地黃湯을 썼으나, 『三因方』은 처방을 수정하여 淸熱化痰하면서 扶正했다. 3. 赤脈㩌病은 衛氣와 연관이 깊은 少陰 太陽의 관계성으로 설명되었고, 腑虛證에 『千金要方』과 『傷寒總病論』은 石膏地黃湯을 사용했으나, 『三因方』은 扶正祛邪했다. 4. 黃肉隨病은 太陰 陽明쪽의 문제로 三焦寒濕不調하여 발생했고, 臟實證에 『千金要方』과 『傷寒總病論』은 玄參寒水石湯을 사용했으나, 『三因方』에서는 扶正祛邪했고, 腑虛證에는 『三因方』에서 溫中燥濕·補脾益氣하였다. 5. 白氣狸病은 太陰과 太陽의 관계성 속에서 설명되었고, 腑虛證의 치법에 『千金要方』과 『傷寒總病論』은 石膏杏仁湯을 사용했으나, 『三因方』에서는 扶正祛邪했고, 臟實證에 『千金要方』과 『傷寒總病論』은 石膏葱白湯을 사용했으나, 『三因方』은 扶正祛邪했다. 6. 黑骨溫病은 太陽 少陰의 相搏으로부터 三焦에 쌓이고 막혀서 발생했고, 臟實證에 『千金要方』과 『傷寒總病論』에서 苦參石膏湯을 사용했으나, 『三因方』에서는 扶正祛邪했다. 臟腑溫病은 五臟을 위주로 하면서도 表裏를 이루고 있는 六腑와의 경락적인 측면도 함께 고려한 疫病의 명칭으로 코로나 19 증상에서도 관련 처방을 응용해 볼 수 있다고 생각한다.

영어초록

Objectives : The purpose of this paper is to examine the mechanism and treatment of the Zangfu warm disease in the Beijiqianjinyaofang.
Methods : This study examined the Zangfu warm disease content in the Beijiqianjinyaofang, Shanghanzongbinglun, Saninfang, based on the Neijing explanation of the pathological mechanism. Treatment was analyzed among the three texts in terms of their similarity and difference.
Results & Conclusions : 1. Zangfu warm disease is caused by seasonally inappropriate qi, which is infectious, epidemic, and seasonal. 2. While the Qingjinqian disease pattern was explained in terms of the relationship between Shaoyin and Shaoyang, the actual disease pattern happened more in the Taiyang channel, and partly in the Shaoyang channel. For treatment of Fu deficiency pattern, the Chaihudihuangtang was listed in the Qianjinyaofang and the Shanghanzongbinglun, while in the Sanyinfang, the formula was modified to extinguish heat and thin phlegm, while reinforcing healthy qi. 3. The Chimaifei disease pattern was explained in terms of the relationship between Shaoyin and Taiyang that is deeply associated with Wei qi. For treatment of Fu deficiency the Qianjinyaofang and Shanghanzongbinglun used the Shigaodihuangtang, while the Sanyinfang reinforced healthy qi and eliminated pathogenic qi. 4. The Huangrousui disease pattern was explained as being caused by problems in the Taiyin and Yangming, in which the Triple Burner fails to control and manage cold dampness. In treating Zang excessiveness, the Qianjinyaofang and Shanghanzongbinglun used the Xuanshenhanshuishitang, while the Sanyinfang instructed to reinforce healthy qi and eliminate pathogenic qi. In treating Fu deficiency, the Sanyinfang instructed to warm the center and dry dampness, tonifying the Spleen and reinforcing qi. 5. The Baiqili disease pattern was explained within the relationship between Taiyin and Taiyang. In treating Fu deficiency, the Qianjinyaofang and Shanghanzongbinglun used the Shigaoxingrentang, while the Sanyinfang instructed to reinforce healthy qi and eliminate pathogenic qi. In treating Zang excessiveness, the Qianjinyaofang and Shanghanzongbinglun used the Shigaocongbaitang, while the Sanyinfang instructed to reinforce healthy qi and eliminate pathogenic qi. 6. The Heiguwen disease pattern was explained as being caused by stagnation and obstruction in the Triple Burner due to clash between Taiyang and Shaoyin. In treating Zang excessiveness, the Qianjinyaofang and Shanghanzongbinglun used the Kushenshigaotang, while the Sanyinfang instructed to reinforce healthy qi and eliminate pathogenic qi. The Zangfu Warm Disease is a infectious disease concept which is based on the Five Zang that integrates the meridian aspect together with the Six Fu with which there is an external/internal relationship. This concept and treatment could be considered in dealing with COVID-19.

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