基于《黄帝内经》语境探析“阳加于阴谓之汗”
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R221

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天津中医药大学第二附属医院“薪火相传计划”后备人才项目(津中医二附政发〔2023〕50号);天津中医药大学第二附属医院引 进博士人才培养项目(津中医二附政发〔2025〕104号)


Exploration of the Original Meaning of "When Yang Overwhelms Yin, It Is Termed Abnormal Sweating" Based on the Context of Huang Di Nei Jing
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    摘要:

    “阳加于阴谓之汗”出自《素问·阴阳别论》,其义历代阐发颇丰,然多侧重于生理性汗出机制或泛化病理解释,与原文辨脉断症的语境未尽相合。本文通过系统梳理《黄帝内经》“汗”相关理论,并运用训诂学、语境分析及中医理论方法,对经典原文进行考辨与重释。研究发现,“加”字于先秦两汉文献中常蕴含“凌驾”“逼迫”之意;且《素问·阴阳别论》中“……谓之……”句式所涉7处,皆指具体病证或特定生理状态,故“阳加于阴谓之汗”之“汗”应理解为需被诊断的异常汗出(病汗)。因此,该论述应具有双重内涵,既是《素问·阴阳别论》脉诊体系中的一个诊断要素,同时又高度概括了病汗的核心病机。本文旨在回归经典原文的诊断学本义,厘清后世医家阐释中的思维误区,揭示其从具体诊法向核心病机升华的理论路径,为临床辨析汗证提供源于经典的理论方法。

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    Abstract:The phrase "when yang overwhelms yin,it is termed abnormal sweating" originates from Su Wen·Yin Yang Bie Lun (Chapter Ⅶ of Basic Questions). Its meaning has been interpreted in various ways throughout history; however, most interpretations tend to explain the physiological mechanism of sweat secretion, which does not fully align with the original context of pulse diagnosis and disease differentiation. By systematically reviewing the discourse on "sweating" in Huang Di Nei Jing (The Yellow Emperor's Inner Classic),and employing philological,contextual,and traditional Chinese medicine theoretical methods, this paper examines and reinterprets the classical text. The study finds that the character "jia" in pre-Qin and Han dynasty texts often conveys the meanings of "to overwhelm" or "to press upon." Moreover, all seven instances of the sentence pattern “ …wei zhi… ” in Su Wen·Yin Yang Bie Lun refer to specific diseases or particular physiological states. Therefore,"sweating" in "when yang overwhelms yin,it is termed abnormal sweating" should be understood as pathological sweating requiring diagnosis. Accordingly, this statement should carry a dual connotation:it is both a diagnostic element within the pulse diagnosis system of Su Wen·Yin Yang Bie Lun and a highly generalized core pathogenesis of pathological sweating. This paper aims to return to the original diagnostic meaning of the classical text,clarify interpretative misunderstandings in later commentary,and reveal the theoretical path by which it ascended from a specific diagnostic method to a core pathogenesis, thereby providing a classical-text-derived theoretical approach for the clinical differentiation and analysis of sweating disorders.

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王延洲,邵长俊,赵志恒.基于《黄帝内经》语境探析“阳加于阴谓之汗”[J].新中医,2026,58(20):134-138

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  • 在线发布日期: 2026-10-21
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