朱丹溪与张景岳对阴虚认识以及滋阴治法之异同比较  

Comparison of the Similarities and Differences between ZHU Danxi’s and ZHANG Jingyue’s Understanding of Yin Deficiency and the Treatment Method of Nourishing

作　　者：李梦茜 宋佳 Yin LI Mengxi;SONG Jia(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院,北京100029

出　　处：《浙江中医药大学学报》2024年第3期319-323,共5页Journal of Zhejiang Chinese Medical University

基　　金：北京中医药大学“揭榜挂帅”项目(2023-JYB-JBQN-071);任应秋“階墀基金”项目(2023-RYQJC-006)。

摘　　要：[目的]梳理总结朱丹溪与张景岳的滋阴理论,探讨二位医家对阴虚的认识以及滋阴治法的异同。[方法]通过文献学研究方法,研读朱丹溪和张景岳主要著作中与“阴虚”有关的内容,查阅相关文献,分析两者滋阴理论、阴虚分类、滋阴治法的异同之处。[结果]朱丹溪治疗阴虚之证以“阳有余阴不足论”及“相火论”为理论基础,以相火妄动为阴虚证产生的主要病机,治法上重视苦寒降火,善用知母、黄柏等苦寒之品,补阴与降火并重。而张景岳以“阴阳一体”“真阴为阳气之根”为理论基础,认为真阴不足既可导致阴虚,又可阴损及阳而致阳虚,并提出阴虚有二,阴中水亏与阴中火衰,治疗上重视纯补真阴,重用熟地黄等甘温填精之品,提倡阴阳互济之法。[结论]无论是滋阴思想还是具体治法方药,张景岳对朱丹溪既有继承又有突破,进一步完善了中医学的滋阴理论及温补学说,并创制了一系列以填补真阴为基础的方剂。研究两者思想理论与临床证治的异同,对于梳理滋阴治法的发展脉络具有重要意义。[Objective]To sort out and summarize the theory of nourishing Yin of ZHU Danxi and ZHANG Jingyue,and discuss the similarities and differences of two doctors’understanding of Yin deficiency and the treatment method of nourishing Yin.[Methods]Through the research method of documentics,this paper carefully studies the contents related to“Yin deficiency”in the major works of ZHU Danxi and ZHANG Jingyue,as well as relevant literature reports and analyzes the similarities and differences of the theory of nourishing Yin,classification of Yin deficiency and the treatment method of nourishing Yin between them.[Results]ZHU Danxi’s treatment of Yin deficiency syndrome was based on the theory of“an excess of Yang with deficiency of Yin”“ministerial fire(Xianghuo)”.He took the hyperactivity of ministerial fire as the main pathogenesis of Yin deficiency syndrome.In the treatment method,he paid attention to reducing fire,and made good use of the bitter and cold products such as Anemarrhenae Rhizoma(Zhimu)and Cortex Phellodendri(Huangbai),and paid equal attention to nourishing Yin and reducing fire.ZHANG Jingyue,on the basis of the theory that“Yin and Yang are one”and“true Yin was the foundation of Yang Qi”,believed that the deficiency of true Yin can lead to Yin deficiency and Yang deficiency,and proposed that Yin deficiency had two aspects:water deficiency in Yin and fire deficiency in Yin.In the treatment method,nourishing true Yin by the sweet and warm medicines such as Radix Rehmanniae Preparata(Shudihuang)was emphasized,and Yin Yang mutual aid was advocated.[Conclusion]Whether it is the thought of nourishing Yin or the specific treatment and prescription,ZHANG Jingyue inherited and made a breakthrough on ZHU Danxi.He further improved the theory of nourishing Yin and the theory of warm recuperation in traditional Chinese medicine,and created a series of prescriptions based on nourishing true Yin.It is of great significance to study the similarities and differences of their thought,theory,clinical sym

关 键 词：朱丹溪 张景岳 滋阴治法 相火 滋阴降火 真阴 阴阳一体 

分 类 号：R221[医药卫生—中医基础理论]