淋证是临床常见病证，病情易迁延、反复，现代医学以抗生素治疗为主，但面临耐药与易复发等困境，严重影响患者生活质量。中医认为，其核心病机在于“大气失转，枢机不利”，导致三焦水道壅滞，肾与膀胱气化功能失常，病位虽在下焦，实则与肺、肝、胆、心、脾、肾等多脏腑功能密切相关。治疗应以“疏利少阳，运转大气”为基本治则，以小柴胡汤为基础方和解枢机，并随证配伍清热利湿、温肾化气、健脾固本等法，旨在恢复三焦气化与水液代谢功能，以达到“大气复转，水道自通”之效。该治法体现了中医从整体出发、标本兼治的辨证思想，为淋证的临床诊治提供参考。

       Strangury is a common clinical disease characterized by its persistent and recurrent course．Modern medicine primarily employs antibiotic therapy，yet challenges such as drug resistance and high recurrence rates remain，significantly affecting patients’ quality of life．In traditional Chinese medicine（TCM），its core pathogenesis involves “impaired movement of the Great Qi and obstruction of the pivotal mechanism”，which leads to stagnation of the Sanjiao water passages and dysfunction of qi transformation in the kidney and bladder．Although the disease is located in the lower Jiao，it is closely related to dysfunction of multiple organs，including the lung，liver，gallbladder，heart，spleen，and kidney．The treatment should follow the principle of “soothing and promoting Shaoyang，circulating Great Qi．” Xiaochaihu Decoction is used as the basic formula to harmonize the pivot mechanism，supplemented with therapies such as clearing heat and draining dampness，warming the kidney to promote qi transformation，and strengthening the spleen to consolidate the root，based on syndrome differentiation．This aims to restore the qi transformation function of the Sanjiao and water metabolism，thereby achieving the therapeutic goal of “restoring the movement of Great Qi and freeing the water passages．” This approach reflects TCM’s holistic concept and its dialectical thinking of addressing both root and branch，providing a reference for the clinical diagnosis and treatment of strangury．