基于 《黄帝内经》 中 “粗守关，上守机” 的观点，从“守关”“守机”的角度探讨痹证的诊治。认为五体（皮、脉、 肉、筋、骨）病变为痹证病变之“关”，气血失和为痹证病变之“机”；通过查关以明确病变部位，审机以明确气血状态；治 疗痹证，“守关”以恢复病变区域的结构正常，“守机”以维持气血充盈和运行稳定，兼顾局部病变与整体气血的调整。“守 关”与“守机”同等重要，二者相辅相成。在遵循对病变“关口”的精准审查和对气血流转之“机”的细致调控的原则下， 视正邪虚实、病邪性质、病变层次等因素进行调整，方可取得显效。基于“守关”“守机”理论诊治痹证可拓展痹证的临证 思路。

The view of “inferior practitioner guarding the gate while the superior practitioner keeping the trigger” during the clinical practive was recorded in in Huang Di Nei Jing（Huangdi’s Cannon of Medicine）. This paper probes into the diagnosis and treatment of bi-syndrome from the perspecitve of “guarding the gate” and “keeping the trigger”. It is proposed that the lesion of five body constituents （i. e.，skin，vessel，muscle，tendon，and bone） constitutes the injured “gate” of bi-syndrome，and the disharmony of qi and blood constitutes the “trigger” of the onset of bi-syndrome. The location of lesions will be found through examining the gate，and the state of qi and blood will be confirmed after checking the trigger. For the treatment of bi-syndrome，“guarding the gate” is to enable the normality of five body constituents， and “keeping the trigger” is to maintain the abundance and harmony movement of qi and blood，which cover the consideration of focal lesions and the regulation of holistic qi and blood.“Guarding the gate” is as important as “keeping the trigger”，and the two are interrelated. Only by carefully examining the gate of the lesions and strictly checking the trigger of qi-blood movement，it is possible to identify the deficiency of healthy qi and the excess of the pathogens，the nature of the pathogens and the severity of illness of bi-syndrome，and then the corresponding therapeutic methods can be performed to achieve the efficacy. The view of “guarding the gate” and “keeping the trigger” expands the clinical approach to the diagnosis and treatment of bi-syndrome.

R255.6

国家自然科学基金项目（编号：82405556）；中国博士后基金项目（编号：2024M750464）；广东省基础与应用基础研究基金项目 （批号：2023A1515110682）；广东省中医药局中医药科研立项项目（粤中医函[2022]197号）；广东省名中医传承工作室建设项目（粤中医办函 [2023]108号）；佛山市名中医传承工作室建设项目（佛卫办函[2022]106号）；佛山市十四五重点专科建设项目（佛卫函[2020]15号）