李东垣内伤病辨治思路探析及思辨  

Exploration and Reflection on the Differentiation and Treatment of Li Dongyuan's Internal Injury Disease

作　　者：赵妍婕 刘世威 宋素花[1] ZHAO Yanjie;LIU Shiwei;SONG Suhua(Shandong University of Traditional Chinese Medicine,Ji'nan 250355,China)

机构地区：[1]山东中医药大学,济南250355

出　　处：《中国中医基础医学杂志》2024年第2期185-189,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：2022年度齐鲁医派中医学术流派传承项目(鲁卫函〔2022〕93号);山东省研究生教育优质课程建设项目(SDYKC20054);山东中医药大学第三期123人才工程项目。

摘　　要：《内外伤辨惑论》为金元四大家李东垣著作之一,其卷中部分主要论述了内伤病的病机证治等内容。李东垣所论内伤病是由脾胃受损所导致的一种不足之病,生理基础主要与脾胃的生成和布散精微功能有关,核心病机为脾胃受损所导致的精气不足及阴火上冲,时令主气也会改变内伤病的主要矛盾。针对不断变化的病机,李东垣立甘温除热、补气升阳等法,又有补中益气汤、参术调中汤等方随于后,形成了完整的内伤病辨治体系。李东垣理法十分精妙,多脱胎于先贤经典,笔者在文献梳理的基础上,选甘温除热、按而收之、风药升阳三点,思辨推敲其本义,以便灵活运用于临床。Nei Wai Shang Bian Huo Lun is one of the works of Li Dongyuan,the four great masters of Jin and Yuan dynasties.The middle volume mainly discusses the pathogenesis,syndrome and treatment of internal injury disease.Dongyuan's internal injury disease is a deficiency disease caused by the damage of spleen and stomach.The physiological basis is mainly related to the function of the spleen and stomach to produce and disperse essences.The core pathogenesis is the deficiency of essence and Qi and the upward rush of Yin fire caused by the damage of spleen and stomach.Seasonal dominant Qi will also change the main contradiction of internal injury disease.In view of the changing pathogenesis,Dongyuan established methods like relieving fever with sweet and warm-natured drugs,invigorating Qi for ascending,followed by Buzhong Yiqi decoction,Shenzhu Tiaozhong decoction and other prescriptions,forming a complete syndrome differentiation and treatment system of internal injury diseases.Dongyuan's theory and method are very exquisite,and most of them are derived from the classics of sages.On the basis of literature review,the author selects three points:relieving fever with sweet and warm-natured drugs,astringing,and wind drug ascending Yang,speculates on its original meaning so that it can be flexibly used in clinic.

关 键 词：李东垣 《内外伤辨惑论》 脾胃 时令 气机升降 甘温 生发 

分 类 号：R229[医药卫生—中医基础理论]