从补中益气汤管窥李东垣脾胃观之阴火论  

Research of the Yin-fire Theory of LI Dongyuan's View of Spleen and Stomach from Buzhong Yiqi Decoction(补中益气汤)

作　　者：罗玥 杨潇[2] 金哲[2] 刘子玉 郭风宜 王智民[3] 尹远平[2] 高天舒[3] LUO Yue;YANG Xiao;JIN Zhe;LIU Ziyu;GUO Fengyi;WANG Zhimin;YIN Yuanping;GAO Tianshu(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁沈阳110034 [3]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2024年第1期79-83,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82274455);国家自然科学基金青年基金项目(82104805);尹远平全国名老中医药专家传承工作室项目;辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金项目(zyzx1804);沈阳市中青年科技创新人才支持计划项目(RC200370)。

摘　　要：“阴火”即内伤之火,其实质为脾胃亏虚,元气虚损所生之内热。“阴火”理论是李东垣提出并应用于临床阐明病机、诊治疾病、遣方用药的重要学说。其产生机制复杂,涵盖内容广泛,自古存在诸多争议,至今未有定论,临床价值尚未完全体现。补中益气汤既是东垣脾胃内伤学说的核心方,也是理解其内伤发热之“阴火”理论的关键。文章将通过探讨李东垣脾胃内伤理论体系中最重要的方剂“补中益气汤”的药物配伍特点及其理论基础,阐述李东垣脾胃观之“阴火”论的学术思想,以及“益气升阳”“甘温除热”的制方思想,浅析“阴火”理论的学术渊源,总结后世医家基于“阴火”理论的临床诊疗应用思路,以期为日后临床工作者应用“阴火”理论临床辨证论治、组方加减提供理论依据。“Yin-fire”is the fire of internal injury,and its essence is internal heat caused by deficiency of spleen and stomach and deficiency of Yuan-Qi.The theory of“Yin-fire”is an important theory put forward by LI Dongyuan and applied to clinical elucidation of pathogenesis,diagnosis and treatment of diseases,prescription and medication.Its mechanism is complex,covering a wide range of contents,there are many disputes since ancient times,so far there is no final conclusion,and the clinical value has not been fully reflected.Buzhong Yiqi Decoction(补中益气汤)is not only the core prescription of Dongyuan's theory of internal injury of spleen and stomach,but also the key to understand the theory of yin and fire of internal injury and fever.By discussing the compatibility characteristics and theoretical basis of the most important prescription“Buzhong Yiqi Decoction”in LI Dongyuan's theoretical system of internal injury of spleen and stomach,this paper expounds LI Dongyuan's academic thought of“Yin-fire”theory of spleen and stomach view.and the prescription thought of“replenishing Qi and rising Yang”and“relieving high fever with sweet and warm-natured drugs”,analyze the academic origin of“Yin-fire”theory,and summarize the clinical diagnosis and treatment application ideas of doctors based on“Yin-fire”theory in later generations.In order to provide a theoretical basis for clinical workers to apply the theory of“Yin-fire”in clinical syndrome differentiation and treatment,prescription addition and subtraction in the future.

关 键 词：补中益气汤 李东垣 阴火 脾胃观 甘温除热 

分 类 号：R249[医药卫生—中医临床基础]