浅析丹溪学说在绝经前后诸证中的临床运用  

Clinical application of Danxi’s theory in syndromes occurring around menopause

作　　者：闫菲 刘雁峰[1] 赵琦 李影 郑志博 孔鑫靓 舒畅 YAN Fei;LIU Yanfeng;ZHAO Qi;LI Ying;ZHENG Zhibo;KONG Xinliang;SHU Chang(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《北京中医药大学学报》2022年第7期728-732,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.82074480)。

摘　　要：元代医家朱丹溪融汇诸家之长并结合自身临证经验创立了滋阴学派,在临证时倡导滋阴降火的治疗法则,对后世影响深远。本文以丹溪学说为着眼点,论述其学术思想的核心内容“阳有余阴不足论”和“相火论”在女子绝经前后诸证病因病机中的体现及在临证治疗中的运用。女性绝经前后诸证的发生以体内精血亏虚为发病之本,以相火妄动、心肾失交为病证之标。在治疗方面,以滋阴降火、补益精血为治疗原则,使离散之相火归其位,临证可用大补阴丸滋肾益阴,并根据五脏六腑相火亢妄随证加减;同时交通心肾,使一身之水升火降,阴阳协调,则君圣臣贤,脏腑调畅。在养生方面,丹溪强调修心养性,克制妄念,使相火不妄动;饮食上应以清淡为主,多食谷菽菜果,少食厚味滋腻。丹溪学说对于女性绝经前后诸证的临证治疗和养生调摄具有重要指导作用,可为后世医家借鉴。Zhu Danxi, a Yuan Dynasty physician, founded the school of nourishing yin by combining the strengths of various schools and his own clinical experience.Zhu Danxi advocated the therapeutic role of nourishing yin and making the fire descend in his clinical practice, which had a profound influence on later generations.This article discusses the core elements of Danxi’s academic theory, the “theory of yang being sufficient but yin being deficient” and the “theory of ministerial fire”, in the etiology and pathogenesis of women’s syndromes occurring around menopause and their application in clinical treatment.The occurrence of syndromes around menopause is based on the deficiency of essence and blood in the woman’s body, and the external manifestations of the disease are delusional movement of ministerial fire, which does not keep its position, and loss of the monarch’s wisdom, which result in disorder of the monarch and minister.In terms of disease treatment, the principle is to replenish essence and blood, nourish yin, and make the fire descend, so that the discrete ministerial fire can return to its place, and patients can be treated with the Dabuyin pill, the dosage of which can be adjusted according to the degree of delusional movement of the ministerial fire in the internal organs.Moreover, the heart and kidney communicate, so that the water and fire, and the yin and yang of the whole body are in harmony;then, the monarch is holy, the ministers are virtuous, and the internal organs are in coordination.From the perspective of health and longevity, Danxi emphasizes the cultivation of the mind and restraint of delusional thoughts, so that the ministerial fire does not move;the diet should also be light, including much grain, beans, vegetables, and fruits, which are less thick and nourishing, for women with syndromes occurring around menopause.Danxi’s theory has significance in the clinical treatment and healthcare for women with syndromes occurring around menopause and can serve as a reference for

关 键 词：丹溪学说 绝经前后诸证 阳有余阴不足论 相火论 

分 类 号：R271.11[医药卫生—中医妇科学]