国医大师张磊从“燮理阴阳”论治汗证  

TCM Master Zhang Lei′s Experience in Treating Sweating Syndrome by Harmonizing Yin and Yang

作　　者：张恒 周月玲 蒋士卿[2] ZHANG Heng;ZHOU Yueling;JIANG Shiqing(Henan General Hospital,Zhengzhou Henan China 450002;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南省职工医院,河南郑州450002 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2024年第8期1713-1717,共5页Acta Chinese Medicine

基　　金：河南省卫生健康委员会中医药传承与创新人才工程(仲景工程)河南省中医药拔尖人才培养项目(202115);第七批全国老中医药专家学术经验继承项目{国中医药人教函〔2022〕76号}。

摘　　要：血瘀、湿热内蕴、邪热郁蒸、阳亢、阴伤、气虚等皆可成为汗证病因,其核心病机为阴阳失和,营卫不调,腠理开阖失利,而致津液外泄失常。临证施治时,遵循“燮理法”进行整体调治。根据汗证的发病规律,基于“燮理阴阳”理论,辨脏腑,五脏同调;辨虚实,精准施治;重配伍,以平为期。同时,汗证的病理性质有虚实之分,治疗时应首辨虚实,再辨气血阴阳。阴虚者,治以滋阴止汗;卫阳虚者,治以固表、调营卫;气血虚者,治以补气养血;邪热郁蒸者,治以清肝泻热。Blood stasis,Dampness-Heat accumulation,pathogenic Heat stagnation and fumigation,Yang hyperactivity,Yin injury and Qi deficiency can all become the pathogenic factor of sweating syndrome,which core pathogenesis is disharmony of Yin and Yang,disharmony of the nutrient Qi and defense Qi,as well as dysfunction of interstitial striae inducing liquid and fluid loss.In clinical treatment,the method of harmonizing is used for holistic regulation.According to the pathogenic regularity and characteristics of sweating syndrome,based on the theory of harmonizing Yin and Yang,the treatment methods are as follows:regulating the five Zang with syndrome differentiation of Zang and Fu;treating accurately with identification of deficiency and excess;balancing Yin and Yang with suitable prescription;modifying the formula flexibly according to syndrome or symptom.Besides,the pathological nature of sweating syndrome can be categorized into two types:deficiency or excess,which should be differentiated first,and then Qi,blood,Yin and Yang should be differentiated.The treatment method for Yin deficiency syndrome is to nourish Yin to stop sweating.For syndrome of defense Yang deficiency,the treatment method is to secure the external,regulate and harmonize the nutrient Qi and defense Qi.Those with Qi and blood deficiency are treated with method of tonifying and replenishing Qi and blood.Those with pathogenic Heat stagnation and fumigation are treated with clearing and purging the Liver Heat methods.

关 键 词：汗证 燮理阴阳 滋阴止汗法 固表调营卫法 补气养血法 清肝泻热法 国医大师 张磊 

分 类 号：R249.27[医药卫生—中医临床基础]