以肝病为例讨论69难母子理论对于临床诊疗的指导
Discussion on the 69th Difficulty Mother-Child Theory Guidance for Clinical Diagnosis and Treatment Using Liver Diseases as an Example

目的：文章主要以通过中医望闻问切相关的“肝病”诊疗为例，就现有的相关资料讨论关于《难经》中69难“虚者补其母，实者泻其子”理论的临床诊疗思路。方法：主要讨论相关医家在运用针灸等中医外治法、中药等方式时提出的各种理解、临床体会及相应思考。结果及结论：在针灸及其他外治法方面：1) 一般在母子经同时出现虚或实的时候应用这个理论，肝心(木火)同实时，即可泻火经火穴，以其肝木生理菽位为标尺的不同判断：沉在阴，浮在阳，从而选取相反阴阳属性火经来对治。2) 在此因“火经”之阴经选取手少阴心经或是手厥阴心包经存在争议，但都取得了很好的临床效果。3) 运用刮痧泻手少阴心经以助治疗肝郁证取得了良好的疗效，提示我们可以在多种外治法中研究69难理论的效果，开拓临床思路。在指导中药使用中：存在质疑单纯肝实之病不应当用泻火中药画蛇添足的，也存在以“互备”修辞手法理解原文——认为应当某脏虚则其母子之脏皆虚补并有临床实证，提示我们在使用本难于用药思路指导上时需要更加灵活地变通，同时药味五行对应母子关系的组方思路是一个需要深入研究的方向。
Objective: This article mainly discusses the clinical treatment strategy of “liver disease” diagnosis and treatment based on TCM’s “look, listen, question and feel the pulse” related methods, using the theory of “empty one should supplement its mother, full one should drain its child” from the “Nanjing” from the Difficult Canon 69 as an example. It mainly discusses the various understandings and clinical experiences of medical practitioners in using acupuncture and other TCM external treatment methods, herbal medicine, etc., as well as corresponding future research thoughts. In terms of acupuncture and other external treatment methods: 1) This theory is generally applied when mother and child meridians are both empty or full. When the liver and heart (wood fire) are in the same state, the fire meridian can be drained by the fire acupoint, with different judgments based on the physiological position of liver wood as the standard: sinking in the yin, floating in the yang, thus selecting the opposite yin-yang attribute fire meridian to treat. 2) There is a dispute on whether to select the yin meridian of the Heart Meridian of Hand-Shaoyin or the Hand-Jueyin Pericardium Meridian as the fire meridian, but both have achieved good clinical effects. 3) Using cupping to drain the Heart Meridian of Hand-Shaoyin to assist in the treatment of liver depression has achieved good therapeutic effects, suggesting that we can study the effects of the 69th difficult theory in various external treatment methods and expand our clinical ideas. In guiding the use of herbal medicine: There is doubt that a simple liver excessive disease should not use fire-draining herbs in vain, and there is an understanding of the “inter-prepared” rhetorical device—believing that it should be the case that if one organ is empty, its mother and child organs are both empty and