李东垣血虚发热论治  

The Treatment of Blood-Deficiency Fever by Li Dongyuan

作　　者：代金成 付强[1] 王天浩 李冀[1,2] DAI Jincheng;FU Qiang;WANG Tianhao;LI Ji(Heilongjiang University of Chinese Medicine,Harbin 150040,China;Key Laboratory of Basic and Applied Research of Northern Medicine,Ministry of Education,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]教育部北药基础与应用研究重点实验室,黑龙江哈尔滨150040

出　　处：《中医药学报》2024年第9期47-50,共4页Acta Chinese Medicine and Pharmacology

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目——李冀全国名老中医药专家传承工作室(国中医人发〔2014〕20号);中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者项目(国中医药人教函﹝2018﹞284号)。

摘　　要：本文认为李东垣所述血虚发热应是血虚之人于暑令之时血不和气,气欲亡散而发热,即血虚为内因,暑令为外因,两因相合始成白虎汤证象的血虚发热。因气欲亡散,故以当归补血汤固摄气机。而从后世医家有关血虚发热病因、证候的不同阐述及治疗血虚发热的不同方剂来看,血虚发热的内涵发生了变化,故笔者通过整理医家选方方义倒推病机,将血虚发热大致分为三种:因暑令而气机浮越之发热、因失血而血脱阳浮之发热、因耗血而血虚阳亢之发热,以期抛砖析理、裨补临证。The authors for this paper believes that the blood-deficiency fever mentioned by Li Dongyuan should be that the blood and qi of blood deficiency person is not harmonious in summer season,and qi cannot be held by the blood and becomes discrete because the blood is deficient.That is,the blood deficiency is the internal cause,the heat is the external cause,and the two causes are combined to form the blood deficiency fever,which is similar to the fever observed in the syndrome of White tiger decoction.Due to the fact that qi is discrete in this case,Chinese Angelica Blood-Supplementing decoction should be applied to astringe qi.The connotation of blood-deficiency fever has changed due to the fact that doctors of later generations provided different causes and syndromes of blood-deficiency fever,as well as different formulae for the treatment of blood-deficiency fever.Therefore,the authors roughly divides blood-deficiency fever into three types by organizing the formulae composed by medical practitioners and inferring the pathogenesis.The three types are qi movement superficially type,which is due to summer season;blood loss and yang floating type,which is due to blood loss;and blood deficiency and yang hyperactivity type,which is due to blood consumption.This classification is to guide medical practitioners to clarify their reasoning and benefit their treatment.

关 键 词：血虚发热 当归补血汤 方证病机 时令气机 天人相应 

分 类 号：R241.8[医药卫生—中医诊断学]