基于“通阳不在温,而在利小便”临证探微  

Clinical Exploration of “Activating Yang Not in Warming,But in Benefiting Urination”

作　　者：谭雨晴 李军[2] 陈恒文[2] 邵祯 TAN Yuqing;LI Jun;CHEN Hengwen;SHAO Zhen(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院广安门医院,北京100053

出　　处：《辽宁中医杂志》2024年第3期40-42,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81973836,82074396);首都卫生发展科研专项重点攻关项目(2020-1-4151);中国中医科学院中医药科技重大成果引导项目(ZZ13-ZD-04);中国中医科学院科技创新工程重大攻关项目(CI2021A05011)。

摘　　要：叶天士著有“通阳不在温,而在利小便”的言论,通阳利水祛湿热在湿热病乃至临床诸症均运用广泛。文章从“通阳不在温,而在利小便”这一条文出发,阐述了其内涵有四:湿热难解,分消辨法;阴阳互资,相互为用;因势利导,升清降浊;通利周身,以和为期。根据理解对其外延进行深入理解有四点:天人合一,阴阳气血转归;阳主阴从,转顺人体枢机;通阳行滞,气郁痰凝血瘀除;开门逐寇,给邪以出路。针对瘀邪痹阻采用清热利湿、提壶揭盖、益气利水、升清降浊、温阳化湿、理气行水之法以通阳利水,以为中医药因势利导、辨证论治提供一定的思路。YE Tianshi wrote the statement that“activating Yang is not in warming,but in benefiting urination”,and the method of activating Yang and inducing diuresis to eliminate dampness and heat is widely used in damp-heat disease and other diseases.Starting from“activating Yang is not in warming,but in benefiting urination”,this paper expounds that its connotation has four aspects:the difficulty in resolving damp and heat,and the method of syndrome differentiation and dissipation;Yin and Yang mutually contribute and utilize each other;guiding according to the situation,ascending the clear and descending the turbid;benefiting the whole body and maintaining a harmonious period.According to the understanding,there are four points for in-depth understanding of its extension:transformation of Yin,Yang,Qi and blood;the passage of Yang from Yin,the cardinal of the human body;activating Yang and removing stagnation,Qi stagnation,phlegm coagulation and blood stasis can be eliminated;opening the door one by one and giving the evils a way out.Aiming at the blood stasis and obstruction,the methods of clearing away heat and dampness,lifting pot and uncovering,invigorating Qi and water,elevating Qi and reducing turbidity,warming Yang and dissipating dampness,and regulating Qi and running water are used to promote Yang and Water,in order to provide some ideas for TCM treatment according to the situation and syndrome differentiation.

关 键 词：通阳 利小便 湿热 

分 类 号：R254[医药卫生—中医内科学]