『상한론(傷寒論)』 결흉(結胸)의 현대적 해석: 인간관계 스트레스 기반의 정신신체 병기(精神身體 病機)로서의 임상적 의미

Abstract

Objective : This study aims to reinterpret Gyeolhyung (結胸) in the Shanghanlun (傷寒論) as a psychosocial–somatic mechanism by analyzing five clinical cases diagnosed with Greater Yang Disease–Gyeolhyung and treated accordingly. Methods : Five cases diagnosed with Gyeolhyung based on the Shanghanlun pattern-identification system were retrospectively collected from three Korean medicine clinics. Chief complaints, psychosocial triggers, symptom patterns, and responses to Hwangryeon-tang (黃連湯), Baekhogainsam-tang (白虎加人蔘湯), and Gamchosasim-tang (甘草瀉心湯) were reviewed. Results : Despite differing chief complaints—including tinnitus, dizziness, fatigue, halitosis, and cranial hyperhidrosis—all cases shared a common psychosocial background characterized by interpersonal tension, fear of social evaluation, and emotional suppression. Symptom patterns corresponded with Gyeolhyung pathology, and herbal medicine resulted in consistent improvement across neurogenic, gastrointestinal, and autonomic symptoms. Conclusions : The findings suggest that Gyeolhyung can be interpreted as a psychosocial–somatic condition in which interpersonal fear and emotional constraint disturb the stomach–autonomic axis, producing diverse clinical manifestations.