摘要
先贤朱丹溪提出“气之病寒者十无一二”,由此创立“气有余便是火”的理论以指导临床。其“相火论”亦为历代医家所广泛接受。阳气、六淫之气、气机及五脏六腑之气有余,皆可化生病理之火,临床多见口干、咽干、耳鸣、消谷善饥、大便干结等症,故当以“气有余便是火”为辨证纲领,施以降气、泻火之法。然临证不可一味清热降火,需详辨病机,针对性地“泻其有余”,尤须谨防苦寒败胃之弊。基于逆向思维,可推衍出“气不足便是寒”的理论。气为万物之资始,气虚失于温煦,则阴寒乘虚而生。卫气、中气、元气及五脏六腑之气不足,皆可致元阳衰微而生寒象,临床常见恶寒、大便溏薄、四肢厥冷等症。通过考辨经典医籍与相关文献,可系统阐述此理论内涵及临证应用要点:见寒象必责其气之不足,或遇气虚之证则当慎投温药。
The sage Zhu Danxi proposed that"there are ten or twelve diseases of qi that are cold",and thus established the theory of"excess qi is fire"to guide clinical practice.His"theory of fire"has also been widely accepted by medical practitioners throughout history.Yang Qi,the Qi of the Six Obstructive Elements,Qi Mechanism,and the excess Qi of the Five Organs and Six Organs can all generate pathological fire.Clinically,symptoms such as dry mouth,dry throat,tinnitus,hunger relief,and constipation are common.Therefore,the principle of"excess Qi is fire"should be used as the diagnostic criteria,and methods of reducing Qi and purging fire should be applied.However,in clinical practice,it is not advisable to simply clear heat and reduce fire.It is necessary to carefully identify the pathogenesis and"eliminate excess heat"in a targeted manner,especially to prevent the harm of bitter cold and stomach deficiency.Based on reverse thinking,the theory of"insufficient qi is cold"can be derived.Qi is the foundation of all things,and when Qi deficiency is lost in warmth,Yin cold arises while taking advantage of deficiency.The deficiency of Wei Qi,Zhong Qi,Yuan Qi,and the Qi of the five organs and six viscera can all cause the decline of Yuan Yang and produce cold symptoms.Clinically,common symptoms include chills,loose stools,and cold limbs.By examining classic medical texts and literature records,the theoretical connotation and clinical application points of this theory can be systematically explained.If the cold phenomenon is observed,it must be attributed to the deficiency of qi,or if qi deficiency is encountered,caution should be taken when administering warm medicine.
作者
李晶晶
韩明
方盛泉
LI Jingjing;HAN Ming;FANG Shengquan(Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to Shanghai Univesity of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《中西医结合慢性病杂志》
2026年第1期55-59,共5页
JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE ON CHRONIC DISEASES
基金
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
上海市自然科学基金项目(20ZR1459300)
上海市级医院消化内科临床能力促进与提升专科联盟项目(SHDC22021311)
上海中医脾胃病优势专科建设项目(YW〔023-2024〕-01-08)。
关键词
脾胃论
气
整体观念
辨证论治
spleen and stomach theory
Qi
overall concept
treatment with syndrome differentiation
