风气内动证候源流与性质探讨  

Study on the Origins and Nature of the Syndrome of Internal Wind due to Qi Movement

作　　者：严涵 胡汉楚 YAN Han;HU Hanchu(Hubei University of Chinese Medicine,Wuhan,Hubei,China,430065;Huanggang Traditional Chinese Medicine Hospital Affiliated to Hubei University of Chinese Medicine,Huanggang,Hubei,China,438000)

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]湖北中医药大学附属黄冈中医医院,湖北黄冈438000

出　　处：《河南中医》2024年第10期1507-1511,共5页Henan Traditional Chinese Medicine

摘　　要：部分内伤杂病可以进展、演化而产生风证,即在杂病基础上产生“风气内动”证候,产生原因为体内气机的失序:热极则令气行盛乱鼓荡,继而生风,引发内风诸证,治疗应以清热为本,热消而诸证自除。若热入营血,宜消热熄风,急投羚角钩藤汤;血能载气,血虚不足则气无所依,失序散乱,而生微风,治宜祛风理血,用救产止痉汤;若气血俱虚,风淫日久,生痰生瘀,可予补阳还五汤;若气随血脱,气快速逸散而崩乱,产生风证,治疗宜遵循“血脱须补气,阳生则阴长”原则,给予东垣保元汤。阴虚动风途径有二,阳亢能化风,阴虚日久生风,阳亢化风证治宜辛甘疏风,缓肝急,滋肾虚,药用羚羊角、栀子、连翘、天花粉、牡丹皮、生地黄等;阴虚生风证治宜补阴为主,兼顾祛邪,方用补液汤。Some miscellaneous internal injuries can progress and evolve into wind syndromes,which can manifest as the syndrome of"internal wind due to qi movement."This condition arises due to the disruption of qi flow within the body:extreme heat causes qi to move excessively,leading to turbulence and,subsequently,the generation of internal wind.This wind,coursing within,triggers various internal wind-related symptoms.The treatment should focus on clearing heat;once the heat subsides,the symptoms will naturally resolve.If the heat penetrates into the nutrient-blood aspects,it is advisable to eliminate the heat and extinguish the wind,using formulas likeAntelope Horn and Uncaria Decoction.Since blood carries qi,when blood is deficient,qi lacks a foundation,leading to qi′s dispersion and disarray.This weaker form of qi produces mild wind instead of a major wind,and the treatment should focus on dispelling wind and regulating blood,using formulas like Emergency Spasm-Relieving Decoction.If both qi and blood are deficient,and internal wind persists,phlegm and stasis may develop,so Yang-Supplementing and Five-Returning Decoction can be used.When qi escapes following blood depletion,a rapid dispersion of qi occurs,resulting in wind syndromes.The treatment should follow the principle that"blood loss requires qi supplementation,as yang grows,yin increases,"so Dongyuan′s Original-Qi-Preserving Decoction can be used.There are two pathways through which yin deficiency leads to wind:yang hyperactivity can transform into wind,or prolonged yin deficiency generates wind.For the syndrome of wind due to yang hyperactivity,the treatment should focus on dispersing wind with acrid and sweet drugs,soothing the liver,and nourishing the kidney,using drugs like Lingyangjiao(Cornu Saigae Tataricae),Zhizi(Fructus Gardeniae),Lianqiao(Fructus Forsythiae),Tianhuafen(Radix Trichosanthis),Mudanpi(Cortex Moutan),Shengdihuang(Radix Rehmanniae),etc.For wind due to yin deficiency,the treatment should prioritize nourishing yin while also dispelling patho

关 键 词：内风 气机 热极生风证 血虚生风证 阴虚动风证 

分 类 号：R255[医药卫生—中医内科学]