天回汉简《脉书·下经》的诊断学成就*

作者：包伯航1，刘 鹏2，蔡业峰1

单位：1.广州中医药大学第二附属医院，广东 广州 510120； 2.广州中医药大学基础医学院，广东 广州 510006

引用：引用：包伯航，刘鹏，蔡业峰.天回汉简《脉书·下经》的诊断学成就[J].中医药导报,2026,32(1):239-245,250.

DOI：10.13862/j.cn43-1446/r.2026.01.040

PDF： 下载PDF

摘要：天回汉简《脉书·下经》是我国现存最早的诊断学专著之一。本文采用文献学和医学的研究手段，对《脉书·下经》中的诊断学内容进行挖掘与阐释。《脉书·下经》是最早记录全身性水肿临床表现及鉴别方法，最早提出黄疸病“三黄症”，最早记录糖尿病患者尿液味甜，最早对腹外疝进行分型分类，最早对子宫脱垂进行分度的历史文献。《脉书·下经》对传世汉唐医籍的影响隐匿而深远，既往认为首见于传世经典的内崩、胸中瘕、疟母、九疸、转胞、阴挺等病名，实际上均源自于《脉书·下经》。《脉书·下经》真实反映了西汉时期我国医学的先进水平。

关键词：《脉书·下经》；天回汉简；心衰；糖尿病；子宫复旧不良；诊断学；《金匮要略》

Abstract：

The Mai Shu·Xia Jing from the Tianhui Han Dynasty Bamboo Slips is one of the earliest extant monographs on diagnostics in China. This paper adopts philological and medical research methods to explore and interpret the diagnostic contents in Mai Shu·Xia Jing. It is the earliest historical document that records the clinical manifestations and differential diagnosis methods of systemic edema, first proposes the "three jaundice types" of jaundice, documents the sweet-tasting urine of diabetes patients for the first time, classifies external abdominal hernia for the first time, and grades uterine prolapse for the first time. The Mai Shu·Xia Jing has exerted a profound yet subtle influence on the handed-down medical books of the Han and Tang Dynasties. Disease names previously considered to first appear in the handed-down classics, such as internal collapse, chest mass, malarial mass, nine types of jaundice, blocked urination and uterine prolapse, actually all originated from the Mai Shu·Xia Jing. The Mai Shu·Xia Jing truly reflects the advanced level of medicine in China during the Western Han Dynasty.

Key words：Mai Shu·Xia Jing; Tianhui Han Dynasty Bamboo Slips; heart failure; diabetes mellitus; subinvolution of uterus; diagnostics; Jinkui Yaolue

发布时间：2026-01-30

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