阳明热盛疾病转归  

On Transmission and Prognosis of Yang Brightness Disease due to Excessive Heat

作　　者：杜威 张文龙 王献 刘英莲 谢毅强[1] 李凯 DU Wei;ZHANG Wen-long;WANG Xian;LIU Ying-lian;XIE Yi-qiang;LI Kai(Hainan Medical University,Haikou,Hainan,China,571199)

机构地区：[1]海南医学院,海南海口571199

出　　处：《河南中医》2022年第9期1297-1300,共4页Henan Traditional Chinese Medicine

基　　金：海南省教育科学“十三五”规划课题项目(QJY20201014);海南省高等学校教育教学改革研究项目(Hnjg2019-67,Hnjg2019-59);海南医学院“新型冠状病毒(2019-nCoV)科技攻关”专项项目(XGZX2020006)。

摘　　要：阳明为多气多血之经,其病多为里实热证,阳热之邪易伤阴液,阳明主胃,喜润而恶燥,津液的不足或者亡失常常是阳明病的关键。病邪从太阳传至阳明,疾病初期当清热护阴,方用白虎汤;热病伤津当清热补阴,方用竹叶石膏汤;热邪炽盛可急下存阴,方用大承气汤。阳明热盛,津伤不解,疾病进一步发展加重,可出现热邪深入下焦,灼伤肝肾精血,方用猪苓汤;急下存阴亦是截断病程之法,方用大承气汤。邪热在阳明气分,热邪亢盛,“壮火食气”,损耗气津,用栀子甘草豉汤补其所伤之气;邪热易阻滞气机,治应祛除病因,用调胃承气汤治疗腹胀,白虎汤治疗热厥,热在上焦,用栀子豉汤;热留中焦,用栀子厚朴汤、枳实栀子豉汤等;用小柴胡汤恢复人体气机运转。阳明邪热波及血分,治宜清热凉血,兼益阴消瘀,方用抵当汤、犀角地黄汤。Yang brightness is a meridian with much qi and blood,and its disease is mostly internal excess heat syndrome.The pathogen of yang heat is easy to hurt yin fluid.Yang brightness meridian governs the stomach and likes to moisten but hates dry-ness.The lack or loss of body fluid is often the key to yang brightness disease.If the disease pathogen spreads from greater yang to yang brightness,in the early stage,the treatment should clear away heat and protect yin,so White Tiger Decoction can be used.For heat disease hurting body fluid,the treatment should clear away heat and replenish yin,so Lophatherum and Gypsum Decoction can be used.For excessive heat pathogen,emergency purgation to preserve yin should be adopted,so Major Purgative Decoction can be used.If excessive heat pathogen yang brightness still injures the body fluid,the disease will further develop and worsen,and the heat pathogen will go deep into the lower energizer and burn the liver and kidney essence and blood,so Polyporus Decoction can be used.If the pathogenic heat is in the qi aspect of yang brightness,and the pathogenic heat is hyperactive,then"high fire will con-sume qi",and lose body fluid,so Gardenia and Licorice and Semen Sojae Praeparatum can be used to supplement the injured qi.Pathogenic heat is easy to block qi,and the treatment should remove the cause.Stomach-Regulating Purgative Decoction can be used to treat abdominal distension,and White Tiger Decoction can be used to treat febrile syncope,and Gardenia and Semen Sojae Praeparatum can be used to treat heat in upper energizer.Minor Bupleurum Decoction can be used to restore the operation of hu-man qi movement.For the pathogenic heat of yang brightness affecting blood aspect,the treatment is to clear heat and cool blood,and nourish yin and eliminate blood stasis,so Resistance Decoction,and Rhinoceros Horn and Rehmannia Decoction can be used.

关 键 词：阳明热盛 阳明病 疾病转归 寒热虚实 轻重缓急 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]