甘温除大热的临床应用分析  

An analysis of clinical application of sweet and warm-natured medicinals in relieving severe fever

作　　者：贺晨 吴乾 杨婉[1] 张黎昕 HE Chen;WU Qian;YANG Wan;ZHANG Lixi

机构地区：[1]山西中医药大学,山西太原030024 [2]山西省肿瘤医院,山西太原030000

出　　处：《中医临床研究》2024年第12期114-117,共4页Clinical Journal Of Chinese Medicine

摘　　要：甘温除大热是由金元时期李杲(号东垣)首创,运用味甘性温的方药治疗虚损劳倦引起的发热的一种方法。其代表方剂为补中益气汤,可用于治疗脾胃损伤,元气虚弱,邪毒(李杲称阴火)内生或邪气内侵,邪正相争所致的热证。甘温除热法自提出以来在临床上广泛应用,后世医家在其基础上创立了当归补血汤、归脾汤、人参养荣汤等治疗气虚发热或血虚发热。目的:吴乾医师在临床中应用甘温除热之法治疗癌性发热有其独到的体会,今选其治验3则并浅析体会,探讨“甘温除热”在治疗癌性发热中的应用,以此论证中医内伤发热学说,为现代医学难以解决的内伤发热诸证,尤其癌性发热提供思路。方法:通过病案分析癌性发热的本质与内涵、中医对癌性发热的认识,探索癌性发热与虚症发热的相通性。结果:癌性发热多以气血虚为基本病机,甘温除热法是以补气温阳、扶正散火为主的治疗方法,癌性发热在辨治上与其有相通之处。结论:癌症多为各种致癌因子长期作用于人体导致。病机多属气血亏虚,邪气亢盛。气血虚则无以敛阳,阳气无所附,虚阳亢奋而致发热。故应立足于虚热之本,以甘温药物补充中阳之气,辅助以补血之品,补虚敛阳,以收除热之功。Sweet and warm-natured medicinals relieving severe fever is initiated by LI Gao in the Jin and Yuan Dynasties,as a method to treat the fever caused by deficiency and fatigue.Its representative prescription is Buzhong Yiqi decoction(补中益气汤),which can be used to treat the heat syndrome caused by spleen and stomach injury,vital Qi(气)weakness,endogenous evil poison(LI Gao referred it as Yin fire)or evil Qi internal invasion,evil and positive Qi competition.Since it is put forward,sweet and warm-natured medicinals relieving severe fever has been widely used in clinical practice.On the basis of it,later doctors created Danggui Buxue decoction(当归补血汤),Guipi decoction(归脾汤)and Renshen Yangrong decoction(人参养荣汤)to treat Qi deficiency fever or blood deficiency fever.Objectives:Physician WU Qian has his unique experience in the clinical application of the method of applying sweet and warm-natured medicinals in relieving severe fever for the treatment of cancer fever.This article selects three of his test cases and analyzes his experience to explore the application of“Sweet and warm-natured medicinals relieving severe fever”in the treatment of cancer fever,in order to demonstrate the theory of internal injury fever in traditional Chinese medicine,and provide ideas for the symptoms of internal injury fever that are difficult to be solved by modern medicine,especially cancer fever.Methods:The essence and connotation of cancer fever,the understanding of cancer fever in traditional Chinese medicine are analyzed,and the connection between cancer fever and deficiency fever is explored.Results:The basic pathogenesis of cancer fever is deficiency of Qi and blood.The method of removing heat with sweet and warm-natured medicinals is the main therapeutic method of supplementing Qi and warming Yang(阳)and strenghtening healthy Qi and dispersing fire.There are some similarities in the differentiation and treatment of cancer fever.Conclusion:Cancer is mostly caused by various carcinogenic factors act

关 键 词：甘温除热 肿瘤 阳虚发热 虚热 

分 类 号：R285[医药卫生—中药学]