刘完素“火热致中”理论与证治  

Liu Wan-su's Theory of"the Heat-Fire Leading to the Middle Energizer"and Syndrome Treatment

作　　者：刘娜 崔友祥[2] LIU Na;CUI You-xiang(School of Traditional Chinese Medicine,North China University of Science and Technology,Tangshan,Hebei,China,063210;Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei,China,061000)

机构地区：[1]华北理工大学中医学院,河北唐山063210 [2]河北省沧州中西医结合医院,河北沧州061000

出　　处：《河南中医》2023年第5期675-678,共4页Henan Traditional Chinese Medicine

摘　　要：刘完素提出“六气皆从火化”“五志过极皆为热甚”,在病机上独创“火热论”,并在此基础上倡导“火热致中”理论,认为“火热致中”的关键病机为“怫热郁结,气血不通”,本质为水亏火旺,以“清泻火热、活血通经、调和脏腑”为治则。刘完素认为,中风有邪中于脏与邪中于腑之别,邪中于腑者“有表证、多著四肢”,常因外感之邪与内生火热相兼为病;中脏者则有“唇吻不收,舌不转而失音……多滞九窍”的特点。“中腑者宜汗之,中脏者宜下之。”常用麻黄续命汤、桂枝续命汤、大秦艽汤、地黄饮子、三化汤、愈风汤等治疗。中风先兆与中风同根而生,故亦从寒凉论治,宜“先服祛风涤热之剂,辛凉之药,治内外之邪”,常用八风散、天麻丸、愈风汤等未病先防。中风者火热程度因人而异,疾病不同阶段的火热热势亦不同,用药不可太过寒凉,亦不可过汗、过下,故治疗上虽以寒凉药物为主,亦辅加辛热之祛风药以行血散结通经,常用至宝丹、灵宝丹。Liu Wan-su proposed that"six types of pathogenic factors can all be transformed into pathogenic fire under certain conditions"and"five excessive kinds of emotions can transform into pathogenic fire".He pioneered the"theory of fire-heat"in the pathogenesis of the disease,and based on this,advocated the theory of"fire-heat affecting the middle energizer".He believed that the key pathogenesis of"fire-heat affecting the middle energizer"is accumulation of heat and stagnation of qi and blood",which is essentially deficiency of water and excess of fire.The treatment principle should be"clearing fire-heat and promoting blood circulation and dredging meridians,and harmonizing the zang-fu organs".According to Liu Wan-su,there is difference between pathogens due to stroke attacking zang organs and attacking fu organs.The pathogens attacking fu organs"have exterior syndromes mostly in limbs",resulting from combination of external pathogenic factors and internal fire and heat,while the pathogens attacking zang organs"have the characteristic of not retracting the lips and not turning the tongue,leading to failure to speak,and they often obstruct the nine orifices".Ephedra Life-Sustaining Decoction,Cinnamon Twig Life-Sustaining Decoction,Large Gentian Decoction,Rehmannia Drink,Three-Transformation Decoction,Wind-Removing Decoction,etc.are often used.The premonition of stroke originates from the same root as that of stroke,so it is also treated from the perspective of cold and cool.It is advisable to"first take drugs that dispel wind and heat,and drugs that are spicy and cool to treat internal and external pathogens.In order to prevent diseases before they occur,some formulas are commonly used,such as Eight Wind Powder,Gastrodia Pills,and Wind-Removing Decoction,etc.The fire-heat degree of stroke patients varies from person to person,and the fire-heat intensity varies at different stages of the disease.Medication should not be excessively cold,nor should it cause excessive sweating or purging.Therefore,although cold and cool dr

关 键 词：“火热论” “火热致中” 中风 刘完素 

分 类 号：R255.2[医药卫生—中医内科学]