从火论治喉痹源流初探  

A preliminary study on the source and flow of treating throat impediment from the aspect of fire

作　　者：李永红 王丹 杨文婷 陈响 于鑫 邱丽蓉 王惠敏 张俞 LI Yonghong

机构地区：[1]北京市通州区中西医结合医院,北京101100

出　　处：《中医临床研究》2023年第34期65-68,共4页Clinical Journal Of Chinese Medicine

基　　金：北京市通州区高层次人才发展支持计划项目(YHLD2017018)。

摘　　要：咽喉为人身饮食门户,呼吸关隘。喉痹的记载最早见于《黄帝内经》,痹是闭塞不通之意。喉痹是临床常见病证,其主要症状有咽干咽痒,咽喉肿痛、灼热感、异物感等,影响呼吸和进食,严重者甚至呼吸及吞咽困难。阴阳调和则咽喉清利,气道宣畅;若饮食不节,阴阳失于调养,可致热毒壅滞于喉而发病,另外脏腑内寒也可致喉痹。中医学认为,喉痹可分为风热、风寒、虚火、阳虚等类型,如宋代严用和指出,不同病因可致喉痹有寒热之分。其病因与火密切相关,可分为虚火、实火。风热以咽部红肿疼痛为主;风寒多因体弱,寒邪侵犯所致,寒邪易从热化;虚火者脏腑亏损,虚火上炎,病情较缓;阳虚多见于久病者。在喉痹治疗上,宜根据病情虚实,实火是由于热积于内,应基于火郁发之理论,采用辛散与寒凉药物相结合,以及放血泻火之法来治疗。放血、催吐可降火清痰,迅速起效。治疗虚火宜先解表以透邪外出,不可只用寒凉药物,否则会适得其反而造成内寒,使外邪内闭。文章疏理相关的古代文献,从喉痹与火热的关系出发,根据病情虚实治疗,以阐述从火论治喉痹的文献源流。The throat is the portal of human diet and the breathing pass.Throat impediment was first seen in Huangdi Neijing(《黄帝内经》),and Bi(痹)means blockage and impassability.Throat impediment is a common clinical disease,and its main symptoms include dry itching pharynx,sore pharynx,burning sensation and foreign body sensation in throat,etc.,affecting breathing and eating,and even breathing and swallowing difficulties in severe cases.The harmony of Yin(阴)and Yang(阳)makes the throat clear and the airway unobstructed.If the diet is not proper,it can lead to the loss of Yin and Yang in balance,and then make the heat and poison stasis in the throat and the onset of disease.In addition,the cold in Zang-fu organs(脏腑)can also cause throat impediment.Traditional Chinese medicine believes that throat impediment can be divided into wind-heat,wind-cold,weak fire,Yang deficiency and other types.YAN Yonghe in Song Dynasty pointed out that throat impediment was divided into cold and heat types because of different causes.The etiology is closely related to fire,and it can be divided into deficient fire and excessive fire.The main symptoms of wind-heat were pharyngeal redness,swelling and pain.Wind-cold is mainly caused by invasion of cold due to weak body,while cold syndrome is easily converted to heat syndrome.The Zang-fu organs of patients with deficient fire are feeble,and the disease condition is mild.Yang deficiency is more common in patients with chronic illness.In the treatment of throat impediment,it is appropriate to treat the disease according to the deficieycy or excess condition.Excessive fire is due to the accumulation of heat in the interior,and should be treated with pungent medicines plus cool medicines and blood-letting therapy of releasing intense heat based on the theory of releasing fire stagnation.Bloodletting and promoting emesis can release internal heat and clear phlegm,and have a rapid effect.In the treatment of deficient fire,relieving the exterior symptom should be put in the first place t

关 键 词：喉痹 实火 虚火 火郁发之 放血 

分 类 号：R276.1[医药卫生—中医五官科学]