刘完素基于“火热”论中风  

Liu Wan-su's Opinion on Stroke Based on"the Theory of Fire Heat"

作　　者：史宏硕 沈晓玥 司国民 田虎[1] SHI Hong-shuo;SHEN Xiao-yue;SI Guo-min;TIAN Hu(Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250014;Provincial Hospital Affiliated to Shandong First Medical University,Jinan,Shandong,China,250021)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东第一医科大学附属省立医院,山东济南250021

出　　处：《河南中医》2022年第6期824-827,共4页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81473631);山东中医药大学青年科研创新团队课题项目(22202141)。

摘　　要：刘完素认为,“六气皆从火化”“五志过极皆为热甚”,中风的根本病机为肾水亏虚,心火暴盛,并提出中风是由内而生并非外感,火热也可导致中风。六气之中,火热占二,余风、湿、燥、寒诸气经传变皆能化热生火,由于外感而导致的火热,反复日久,均可化热。五志过则郁,郁结则化火,此为阳气怫郁。对五志过极化火热病机的认识,刘完素从心立论,心主神,心为火脏,为阳中之阳,五志通过心作用,故易于火化为各种疾病,治疗应根据中经络和中脏腑分别在清热基础上,采用“汗”“通”“泻”法。刘完素治疗火热所致中风常用地黄饮子治疗“下元不足,浮火上越”,大秦艽汤治疗“郁火”,三化汤治疗“郁热腑实”。Liu Wan-su believes that"six qi can all transform into fire",and"five excessive emotional activities can transform into heat".The fundamental pathogenesis of stroke is kidney water deficiency and excessive heart fire,and puts forward that stroke is caused by internal pathogen rather than external one,and fire heat can also lead to stroke.Among the six qi,fire and heat account for two.The remaining wind,dampness,dryness and cold can transform heat into fire through transmission and change.The fire and heat caused by repeated long-time external factors can turn heat.Five excessive emotional activities lead to depression,and depression may turn into fire.This is yang qi depression.Liu Wan-su′s understanding of the pathogenesis of five excessive emotional activities transforming into heat is from the heart.The heart governs the spirit.The heart is the fire organ,which is the yang within yang.The five emotional activities act through the heart,so it is easy to lead to various diseases.The treatment should adopt the methods of"sweating","dredging"and"purgation"respectively on the basis of clearing heat for affecting meridians and viscera.Liu Wan-su often uses Rehmannia Drink to treat"depletion of the lower origin,and ascending floating fire",Large Gentian Decoction to treat"stagnant fire",Three Transformation Decoction to treat"stagnant heat and viscera excess syndrome."

关 键 词：中风 火热论 “六气皆从火化” “五志过极皆为热甚” 地黄饮子 大秦艽汤 三化汤 刘完素 

分 类 号：R255.2[医药卫生—中医内科学]