杨瑞兰 老膺荣

    [摘要] 运气辨治是主流辨证论治以外的另一种思维方式，更重视中医病机的作用。自汗为临床常见疾病。在五运六气视角下，自汗基本病机为金运不及，炎火乃行。紫菀汤为陈无择在《三因极一病证方论》中针对六乙年金运不及所设方剂。基于运气理论并结合顾植山教授辨象-辨时-握机的思維模式，运用紫菀汤治疗自汗效果满意。本文通过分析两则自汗验案的运气病机特点及诊疗过程，介绍五运六气理论指导下三因司天方紫菀汤治疗自汗的临床辨证思路，为临床诊疗自汗提供新的参考和理论依据。

    [关键词] 五运六气;紫菀汤;自汗;三因司天方

    [中图分类号] R24? ? ? ? ? [文献标识码] A? ? ? ? ? [文章编号] 1673-7210(2020)03(a)-0127-04

    [Abstract] Clinical syndrome differentiation pattern combined with five evolutive phases and six climatic factors theory is another way of thinking， which pays more attention to the role of traditional Chinese medicine pathogenesis. Spontaneous sweating is a common clinical disease. The deficiency of lung qi causing spontaneous sweating has the basic pathogenesis in the perspective of five evolutive phases and six climatic factors theory. Ziwan Decoction is the prescription of Chen Wuze established in Treatise on Three Categories of Pathogenic Factors， which is pointed at Liu Yi years inferior to metal. Ziwan Decoction treating the spontaneous sweating produces satisfied clinical efficacy under the guidance of five evolutive phases and six climatic factors theory and the thinking of professor Gu Zhishan. Using the theory of five evolutive phases and six climatic factors ......