“邪热不杀谷”的理论探讨  

Discussion on the theory of'evil heat does not digest food'

作　　者：王永涛 孟虎彪 王伟涛 马思佳 谷劼楠 彭彬 徐世杰[1] 张怀亮[4] WANG Yongtao;MENG Hubiao;WANG Weitao;MA Sijia;GU Jienan;PENG Bin;XU Shijie;ZHANG Huailiang(Institute of Basic Theories of Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Traditional Chinese Medicine Information,China Academy of Chinese Medical Sciences,Beijing 100700,China;Beijing University of Chinese Medicine,Beijing 100029,China;The First Affiliated Hospital of Henan University of CM,Zhengzhou 450099,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700 [2]中国中医科学院中医药信息研究所,北京100700 [3]北京中医药大学,北京100029 [4]河南中医药大学第一附属医院,郑州450099

出　　处：《中华中医药杂志》2024年第7期3293-3296,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国中医科学院科技创新工程项目(No.CI2021B001);中国中医科学院中医基础理论研究所基本科研业务费自主选题项目(No.YZ-202220)。

摘　　要：文章考镜了“邪热不杀谷”的源流,该理论首见于《伤寒论·辨脉法》,其本义为伤寒误下后邪热内陷,表现饥而不欲食的状态。后世医家在临床实践中,常运用“邪热不杀谷”理论指导治疗,但对病机的认识存在差异,或认为阳明热毒内盛,或认为肾中相火浮越于上,或认为胃阴不足、虚火内生等。文章还指出“邪热不杀谷”与邪热杀谷的理论混淆,实为不同医家理解有异。阐释了“邪热不杀谷”的理论内涵,即病理之火不能促进饮食水谷的消化吸收,不能将水谷津液转化成充足的气血。同时,还通过2则医案展示了该理论在现代临床实践中的应用。This paper examines the origin of'evil heat does not digest food',The theory was first found in Treatise on Febrile Diseases·Pulse Differentiation.Its original meaning is that the evil heat is insinuated after typhoid fever is mistakenly sent down,showing the state of hunger but not desire to eat.In clinical practice,later doctors often use the theory of'evil heat does not digest food'to guide treatment,but there are differences in the understanding of the pathogenesis.Some people think that Yangming heat toxicity burnt gastrointestinal tract,some people think it is the kidney phase fire floating over,and some people think that the deficiency of stomach yin leads to the production of empty fire,and so on.The paper also points out that the theory of'evil heat not digest grain'is confused with the theory of evil heat killing grain,but different doctors have different understandings.We explained the theoretical connotation of'evil heat does not kill grain',that is,pathological fire can not promote the digestion and absorption of dietary water and grain,and can not transform water and grain body fluid into sufficient qi and blood.At the same time,the paper also shows the application of the theory in modern clinical practice through two medical cases.

关 键 词：邪热不杀谷 邪火不杀谷 理论探讨 腹泻 食欲不振 《伤寒论》 临床应用 源流 

分 类 号：R22[医药卫生—中医基础理论]