从肝经病机论治百合·狐惑·阴阳毒病

Discussion on the Treatment of Lily Disease, Fox Confusion, and Yin-Yang Toxin Disease from the Pathogenesis of Liver Meridian

摘要: 文章基于《金匮要略》经典理论，系统探讨百合病、狐惑病与阴阳毒病的内在病机关联及其与肝经的病理联系。研究提出，三者虽临床表现各异，但均与肝经病变存在密切关联：百合病以肝经气机失调为核心，累及胆腑决渎功能，症见口苦、小便赤涩等并影响决断功能，患者常优柔寡断、谋虑不决；狐惑病病变部位主要集中于肝经颃颡及阴器循行区域，以咽喉蚀烂、前后二阴溃疡为特征，其发病机制与肝经湿热蕴结相关；阴阳毒病则病机与肝经循行咽喉、热毒入血密切相关，临床呈现面赤斑疹及咽喉红肿等典型征象。通过文献溯源与病机分析，本研究阐明三类疾病不仅存在共同的肝经病机基础，且分别对应于肝经不同循行部位的病理改变，其本质为肝经病变不同发展阶段的症候表现。该理论为中医临床辨治提供了新的诊疗思路，凸显肝经论治在相关疾病诊治中的核心地位，具有重要的学术价值与实践指导意义。

Abstract: In this study, based on the classical theories of the “Synopsis of the Golden Chamber”, we systematically investigated the pathomechanistic relevance of lily disease, foxglove disease, and yin-yang toxicosis, with particular emphasis on their common pathological links with the liver meridian. Through comprehensive textual analysis and evaluation of pathomechanisms, we propose that although the clinical manifestations of these three diseases are different, they all show important links with liver meridian pathology at different developmental stages: Lily disease manifests primarily as a dysregulation of the qi of the liver meridian, which secondarily affects the decisive and excretory functions of the gallbladder. Clinical manifestations include a bitter mouth, dark-colored urine, and impaired decision-making ability, which often manifests itself in the patient’s indecisiveness. Fox confusion disease is a localized lesion along the liver meridian route up the pharynx and genital area, manifesting as erosive pharyngitis and genital ulcers. The underlying cause of its development lies in the accumulation of dampness and heat within the Liver meridian. The pathogenesis of yin-yang toxicosis is different in that the heat toxin invades the blood system through the pharyngeal pathway of the liver meridian, with clinical manifestations of characteristic facial erythema and acute pharyngeal inflammation. Through a rigorous literature review and comparative analysis of pathomechanisms, this study determined that these three diseases not only share a common hepatic meridian pathological basis, but also represent different clinical phenotypes corresponding to specific anatomical regions along the hepatic meridian route. The findings suggest that these disorders may be progressive pathologic manifestations of liver meridian dysfunction at different disease stages. This theoretical framework provides new diagnostic and therapeutic perspectives for TCM clinical practice, emphasizing the critical role of liver meridian regulation in controlling these conditions. This study has significant academic value and provides practical guidance for developing meridian-specific treatment protocols for TCM clinical applications.