基于“目中不了了”探讨从目诊辨治阳明急证

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[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 [中图分类号]R276.7 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2025.12.021

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 Yikun²， HU Hongyil* 1.DepartmentofGastroenterologyLonghuaHospitalofhanghaiUnversityofraditionalChineseedicine，hanghai3 China;2.Shanghai FengxianDistrict Traditional Chinese Medicine Hospital，Shanghai 2O140o，China

[Abstract]Yangmingacutepaterns fallwithinthesignificantscopeof emergencycasesinTCM.Byfocusingonthe eyesign"muzhong buliaoliao"（blurredvisionwithimpaiedeyeresponsivenessdescribedintheShangHanLun（Treatise onColdDamage），thispaperexploresthesignificanceofeyediagnosisinthediagnosisandtreatmentof Yangmingacute paterns.Thesignsofeyesserveassensitiveindicatorsforasssing pathogenicheatexuberanceandimpending yinfluid exhaustion.ByreviewingclassicaltextsandmodernresearchonYangmingacutepaterns，and integratingclinicalcases，the pathogenesisisconsideredtoinvolveeitherexuberantfirepervadingthroughoutthebodywithbodyfluidsdepletedby scorching heatorfullness-inducedobstructioninfu-organs，withdisturbedqiascendinganddescending.Basedonthe evolutionofpathogenesis，thetherapeuticprinciplesandmethodsofclearingthemeridianstopurgeheat，benefitingthe stomachtogeneratefluids，unblocking thefu-organstoeliminatestagnation，andclearingfretopreserveyinareproposed. Eyediagnosiscomplementsthelimitationsoftraditionalpatemdiferentiationanddiagnosissystems，andprovidesanojective basisforearlyintervention inYangmingacutepaterns.Thispaperaimstoenrich diagnosticapproaches for Yangmingacute paterns，emphasizingthevalueofTCMdiagnosticprincipleof "detectingsubtlesignstopredictsignficantchanges"inTCM

emergencycases.

[Keywords] eye diagnosis; muzhong bu liao liao;urgent purgation to preserveyin; Yangming acutepaterns; Shang IanLun （Treatise on Cold Damage）; pattern differentiation and diagnosis system

阳明急证属于典型的中医急症，包括阳明经证和阳明腑证，以阳热内结、阴液急剧耗伤为特点。（剩余8036字）