从丹溪学派到温补学派阴虚概念嬗变研究  

Research on Evolution of Yin Deficiency Concept from Danxi School to Warm Supplementation School

作　　者：宋佳 SONG Jia(Teaching and Research Office of Various Traditional Chinese Medicine Theories,School of Traditional Chinese Medicine of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医学院中医各家学说教研室,北京100029

出　　处：《新中医》2024年第21期191-197,共7页New Chinese Medicine

基　　金：北京中医药大学揭榜挂帅项目(2023-JYB-JBQN-071);任应秋“階墀”基金研究专项(2023-RYQJC-006)。

摘　　要：阴虚证是丹溪学派与温补学派共同关注及重点探讨的临床证候。通过梳理从丹溪学派到温补学派“阴虚”概念的嬗变,认为这种概念内涵的嬗变凸显了不同时代对“阴”的具体指代以及对“阴虚”的发生机理、变化转归等认识的不同。朱丹溪本人对“阴虚”的认识就有阴血虚、阴精亏、肾虚、肾水不足等多种内涵;其私淑弟子虞抟认为此“阴虚”当分气中之阴虚、血中之阴虚与肾经之真阴虚;汪机则认为此“阴虚”乃“营虚”,包含营气虚与营血虚两方面。而明代温补学派的薛己认为脾土在阴虚发展转归及治疗过程中至关重要,提出“阴虚”即“脾虚”以及“足三阴虚”的观点;明末张景岳与赵献可则通过发展命门学说,强调人体“真阴”藏于肾命,关乎人体先天之本,内蕴元精可化生元气,包含水火两端,提出“阴虚有二”。温补学派对“阴虚”内涵的发展一则为纠正丹溪学派所造成的苦寒偏弊,另则推动了阴阳学说及藏象学说的深化。Yin deficiency syndrome is a clinical syndrome that both the Danxi School and the Warm Supplementation School focus on and explore.By sorting out the evolution of the concept of"yin deficiency"from the Danxi School to the Warm Supplementation School,it is believed that the evolution of the connotation of this concept highlights the different understandings of the specific reference to"yin"in different eras,as well as the mechanisms,changes,and outcomes of the occurrence of"yin deficiency".ZHU Danxi's understanding of"yin deficiency"included various connotations such as yin-blood deficiency,yin-essence deficiency,kidney deficiency,and insufficient kidney water;his private disciple YU Tuan believed that this"yin deficiency"should be divided into yin deficiency in qi,yin deficiency in blood,and genuine yin deficiency in the kidney channel;WANG Ji believed that this"yin deficiency"is"ying deficiency",which included two aspects:ying qi deficiency and ying blood deficiency.XUE Ji,a scholar of the Warm Supplementation School in the Ming Dynasty,believed that spleen earth was crucial in the development,transformation,and treatment of yin deficiency,and proposed the views that"yin deficiency"was"spleen deficiency"and"deficiency of three yin channels of the foot".In the late Ming Dynasty,ZHANG Jingyue and ZHAO Xianke developed the theory of gate of vitality,emphasizing that the"genuine yin"of the human body was hidden in the kidney gate of vitality,which was related to the innate nature of the human body;theybelieved that the essence contained in it could transform into original qi,including both water and fire,andproposed that there were two types of yin deficiency. The development of the connotation of "Yindeficiency" in the Warm Supplementation School is aimed at correcting the bitter and cold bias caused by theDanxi School, and also promotes the deepening of the yin and yang theory and the viscera manifestationtheory.

关 键 词：阴虚 丹溪学派 温补学派 学派研究 真阴 

分 类 号：R249[医药卫生—中医临床基础]