崔淕榠 孙文军 曲淼 唐启盛

摘要 “躁”于各代医家著述中多有记载，然其内涵却多有不同。文章从“躁”的原始字义入手，考诸历代医典，古今勘照，对躁的内涵及病机进行梳理及探讨。躁的原始字义为疾速与不静，在中医学中则主要包含脉疾、肢体动摇不定与情志不安3种内涵，情志不安之躁，又包括烦躁、狂躁、脏躁等多种表现。躁的核心病机为火热，根据内涵及病程的不同，其具體病机也不尽相同，应分为实证与虚证两类分别探讨。

关键词 烦躁;狂躁;脏躁;肝郁化火;痰火扰心

Discussion on Connotations and Pathogenesis of “Zao”

CUI Luming1，SUN Wenjun2，QU Miao3，TANG Qisheng2

（1 Beijing University of Chinese Medicine，Beijing 100029，China; 2 Beijing University of Chinese Medicine Third Affiliated Hospital，Beijing 100029，China; 3 Xuanwu Hospital Capital Medical University，Beijing 100053，China）

Abstract There are many records of “zao” in the writings of various generations of doctors，but the connotations of it are quite different.Starting from the original meaning of “zao”，this paper examines all-time Chinese medical books，discusses the connotations and pathogenesis of “zao”.The original meaning of “zao” is rapidity and restlessness.In Traditional Chinese Medicine，it mainly contains three connotations：the pulse fast，body moving and emotional restlessness.Emotional restlessness also includes many symptoms such as fidgety，manic，uneasiness and so on.The core pathogenesis of mania is heat，and its specific pathogenesis are different according to the different connotations and course of disease，which should be discussed by dividing into positive syndrome and deficiency syndrome.

Keywords Fidgety; Manic; Uneasiness; Fire Derived From Stagnation Of Liver-QI; Phlegm-fire harassing the heart system pattern

中图分类号：R228文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.01.020

中医中的“躁”，首见于《黄帝内经》，随着时代的发展，历代医家对躁的讨论逐渐增多，“躁”的内涵也在不断发生变化。本文从原始字义出发，结合历代古籍和当代文献，梳理“躁”之源流，对其内涵及病因病机进行初步探讨。

1 躁的内涵

1.1 “躁”之字义考证 “躁”字古作“趮”，《说文解字》云：“趮，疾也。从走，喿声”宋代徐铉等注释曰：“今俗别作躁”[1]。《管子·心术上》云：“躁者不静”[2]。《周易·说卦上》云：“震为雷……为决躁……”“巽为木，为风……其究为躁卦”[3]，其中前者之躁为迅疾，后者之躁为动而不止。此外，后世对其出现于《礼记》《论语》《后汉书》等文献中的注释为“动也”“举动急疾”“不安静也”“躁，犹动也”等等。从中可以看出，“躁”字的原始含义，主要为2点：其一为迅疾、快速;其二为好动而不静。

1.2 躁在中医学中的3种内涵

历代医家所论之躁，均为疾速或动而不静之病状，不离上述“躁”的原始字义。纵观各家所言，疾速多用来描述脉疾，动而不静则分为肢体与情志两方面，因此躁在中医学中主要具备3种内涵，兹分述如下。