“虚气留滞”病机理论的考证与发挥  

Textual research and development of the theory of the disease mechanism of‘deficiency of qi and stagnation’

作　　者：金雨静 黄世敬[1] 王永炎[2] JIN Yujing;HUANG Shijing;WANG Yongyan(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《中华中医药杂志》2024年第12期6310-6318,共9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.CI2021A01313);中央级公益性科研院所基本科研业务费专项资金(No.ZZ15-XYLCQ-04);中央高水平中医医院临床科研业务费资助项目(No.HLCMHPP2023035)。

摘　　要：为应对当今更为复杂的人群体质、疾病类型,中医涌现出丰富的创新型病机理论。随着病机理论不断被提出,目前中医界面临着病机理论趋同化的问题,亟待对原有的理论体系做出调整。“虚气留滞”理论由王永炎院士提出,最初将其定义为,由于元气亏虚,气血相失,气血津液运行失常,从而导致气滞、血瘀、痰凝、经络阻滞等的病理过程。“虚气留滞”理论在历代古籍中有系统的理论发挥和临床应用,为充分阐释“虚气”的病理内涵及其致病特点,在系统古籍考证的基础上,提出“虚气”是一种病态的元气,且区别于现有的“内生五邪”理论,在致病特点、脉证及治疗方药上与气虚证、元气亏虚证存在显著差异。“虚气”的致病特点包括容易留滞、容易上冲、游走周身以及易与外邪相合等。“虚气”的治疗以引虚气归元为主,慎用辛味药,防止损耗元气。“虚气留滞”病机理论所呈现的疾病动态演变过程,将可能对理解六经传变、卫气营血病程演进等,提供可行的理论依据,为中医药的多阶段治疗提供更多思路。In response to the more complex body types and diseases of today’s population,a wealth of innovative pathogenic theories have emerged in traditional Chinese medicine(TCM).As theories of disease mechanisms continue to be proposed,the TCM community is now faced with the problem of convergence of theories of disease mechanisms and the urgent need to make adjustments to the original theoretical system.The theory of‘deficiency of qi and stagnation’was proposed by academician WANG Yongyan,who initially defined it as the pathological process of qi stagnation,blood stasis,phlegm coagulation,and meridian blockage due to deficiency of vital energy,loss of qi and blood,and abnormal operation of qi,blood,and fluid.The theory of‘deficiency of qi and stagnation’has been systematically developed and applied in ancient books through the ages.In order to fully explain the pathological connotation of‘deficient qi’and its pathogenic characteristics,on the basis of systematic antiquarian testimony,we propose that‘deficient qi’is a kind of pathological vital qi,which is different from the existing theory of‘internal generation of five evils’and is significantly different from qi deficiency and deficiency of vital qi in terms of symptom expression,pulse characteristics and treatment prescriptions.The pathogenic characteristics of‘deficiency qi’include the tendency to stagnate,to move upward,to wander around the body,and to combine with external evil.The treatment of‘deficiency qi’is based on inducing deficiency qi to return to the yuan,and caution should be exercised in using pungent herbs to prevent damage to the yuan qi.The dynamic process of disease evolution presented by the theory of‘deficiency of qi and stagnation’may provide a feasible theoretical model for understanding the transmission of the six meridians,the evolution of the disease process of Weiqi,ying-blood,and the changes of the disease location of triple energize,and provide more ideas for multistage treatments in Chinese medicine.

关 键 词：虚气留滞 虚气 病机理论 三焦 考证 致病特点 治疗 

分 类 号：R24[医药卫生—中医临床基础]