马勇 周龙云 郭杨 郑苏阳

摘要：骨伤疾患病机以瘀血内阻为共识，而“血不利则为水”之论甚为经典，故笔者思虑血水为患是否为骨伤疾病关键。遂查阅古籍，从多个方面论证活血利水法的重要性，提出骨伤疾患当以活血利水为治法。

关键词：活血利水；骨伤疾病；治则

DOI：10.3969/j.issn.1005-5304.2018.01.021

中图分类号：R274.9 文献标识码：A 文章编号：1005-5304（2018）01-0099-03

Discussion on Applying Removing Blood Stasis and Body Fluid Therapy as Principal of Treating Orthopedics and Traumatology Diseases

MA Yong1，2， ZHOU Long-yun2， GUO Yang2， ZHENG Su-yang2

1. Department of Traumatology & Orthopedics， Affiliated Hospital of Nanjing University of Chinese Medicine （Jiangsu Province Hospital of TCM）， Nanjing 210029， China； 2. Institute of Traumatology & Orthopedics and Laboratory of New Techniques of Restoration & Reconstruction of Orthopedics and Traumatology， Nanjing University of Chinese Medicine， Nanjing 210023， China

Abstract： Blood stasis is mostly seen as the etiology and pathogenesis of orthopedics and traumatology diseases， among which the theory that retention of body fluid comes from blood stasis is the most classical one. Thus， it is meaningful to find out whether the mutual blockage of blood stasis and the body fluid is the key point of orthopedics and traumatology diseases. By consulting the ancient books， the significance of removing blood stasis and body fluid therapy was verified from different aspects， and removing blood stasis and body fluid therapy was proposed to be the principle of treating orthopedics and traumatology diseases.

Keywords： removing blood stasis and body fluid therapy； orthopedics and traumatology diseases； principle of treatment

對于骨伤疾患，历代医家多以活血化瘀为治法，但笔者阅读经典，认为活血化瘀之法尚欠完整，活血利水方为治疗骨伤疾病之要法，兹结合经典阐述如下。

1 关于活血利水治骨伤

基于《素问·举痛论篇》“客于脉中则气不通，故卒然而痛”，历代医家主要以瘀血内阻为骨伤疾患的病机关键，如《正体类要·序》有“肢体损于外，则气血伤于内，营卫有所不贯，藏府由之不和”。但血

基金项目：国家自然科学基金面上项目（81573997）；江苏省高校自然科学研究面上项目（15KJD360001）；江苏省高校优势学科建设工程资助项目（2014年）

水互病的密切相关性却易被后人忽视。《素问·脉要精微论篇》有“肝与肾脉并至，其色苍赤，当病毁伤不见血，已见血，湿若中水也”，《灵枢·营卫生会》“夺血者无汗，夺汗者无血”。这些论述奠定了血水互病的理论基础，仲景对之理解深刻，如《金匮要略·水气病脉证并治》有“血不利则为水”。延至明清时期，医家对血水互病的认识趋于成熟。如《血证论·肿胀》云：“血中有气即有水……是水与血，原并行不悖。失血家，其血既病，则亦累及于水。”《血证论·阴阳水火气血论》“故水病则累血……是血病而兼水”，“血虚即是水虚。