从“灰中有火”理论防治老年慢性肺系疾病  

Prevention and Treatment of Senile Chronic Pulmonary Diseases Based on Theory of“Fire in Ashes”

作　　者：张山 秦欣欣 于会勇 翟志光[2] 王成祥 ZHANG Shan;QIN Xinxin;YU Huiyong;ZHAI Zhiguang;WANG Chengxiang(Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]中国中医科学院中医基础理论研究所,北京100700

出　　处：《山东中医药大学学报》2023年第5期572-576,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82074389);北京市中医药科技发展资金项目(编号:JCZX-2020-02)。

摘　　要：“灰中有火”出自叶天士《温热论》,强调温病后期,患者体内往往尚有余火,治疗用药时应慎用温热之品,防止故病未已,新病复起。老年慢性肺系疾病患者,素有痰热,适逢辛甘厚味、环境燥邪、六淫火气、痰热内生等诱因,容易使邪热内伏,一旦误投,“正气转郁,反致热极”,轻则病重,重则病死,该情况与“灰中有火”理论相一致。故在临床诊治时,提示该类患者应饮食有节、防妄补,治疗既不可一味猛攻,也不能一味进补,应观其脉证,随证治之,常用清补、慎用温补,主次兼施,结合“治上焦如羽,非轻不举”原则,避免闭门留寇,炉灰复燃。The concept of“fire in ashes”comes from YE Tianshi’s Treatise on Warm-Heat Diseases,which emphasizes that in the late stage of warm diseases,patients often have residual fire in their bodies,so warm and hot medicines should be used with caution in medication,so as to prevent the recurrence of old diseases and the emergence of new ailments.Senile patients with chronic pulmonary diseases usually have phlegm heat,which can be aggravated by factors such as consuming acrid,sweet and greasy foods,dry environmental conditions,the pathogenic fire of the six exogenous pathogens and the endogenous phlegm-heat,leading to the accumulation of pathogenic heat within the body.Once mistreated,“healthy qi transforms into qi depression,resulting in extreme heat”,which can lead to severe illness in the mild cases and even death in the severe cases.This situation is consistent with the theory of“fire in ashes”.Therefore,in the clinical diagnosis and treatment,it is suggested that such patients should have a moderate diet and prevent excessive tonic.In the treatment,elimination or tonification should neither be used blindly.Treatment should be based on the pulse conditions and syndromes.Clearing and tonifying method is commonly used while warming and tonifying method is used with caution,treating both the primary and secondary syndromes.Treatment is combined with the principle of“only light and floating medicinals treating the diseases of the upper energizer”,so as to avoid pathogen lingering and the ashes reigniting.

关 键 词：灰中有火 老年 肺系疾病 虚不受补 闭门留寇 《温热论》 清补 温补 

分 类 号：R256.1[医药卫生—中医内科学]