张永康教授基于“阳加于阴,谓之汗”论治汗证经验  

Professor ZHANG Yongkang’s experience in treating sweating syndrome based on“Yang is added to Yin,which is called sweat”

作　　者：范琴琴 王洋 冯咪咪 霍华英[2] 张永康[2] FAN Qinqin

机构地区：[1]山西中医药大学,山西太原030000 [2]山西省人民医院,山西太原030000

出　　处：《中医临床研究》2025年第2期79-83,共5页Clinical Journal Of Chinese Medicine

基　　金：2022年张永康全国名老中医传承工作室建设项目(国中医药人教函[2022]75号);山西省中医药管理局张永康学术经验研究(2019ZYYC041);山西省名中医张永康工作室建设项目[(2018)24-1-16]。

摘　　要：汗,是人体阳气、阴津共同作用下的生理机能表现,若汗液异常外泄,即为汗证。汗证往往是多种因素相互交织、共同作用的结果。其病因有外感六淫、内伤饮食、情志失调、久病体虚等。临证时,汗证可单独出现,展现出其独特的病理特征和临床表现,又可兼夹其他诸多病症。汗证的基本病机为阴阳失调,腠理不固。《黄帝内经》记载:“阳加于阴,谓之汗。”说明汗是阳气蒸腾阴津从腠理而出的产物,汗证的发生发展与阴阳密切相关。张永康教授基于“阳加于阴,谓之汗”思想,认为汗证以阴阳为纲,虽病情复杂多变,虚实夹杂,但从阴阳入手,可快速把握病机,辨证施治。临证虚者多见阴阳气血虚衰,不能固守汗液;实证多因肝火、湿热等郁热熏灼,津液迫出;亦可见到营卫不和所致汗出涔涔。故治疗时虚则补之,实则泻之,营卫不和则调之;施以固阳敛汗、滋阴降火、补气养血、泄热除湿、调和营卫之法。用药时,常选取桂枝加附子汤、理中汤、当归六黄汤等方加减使用,临床效果可靠。研究总结张永康教授从阴阳论治汗证的临证经验,以期为临床治疗汗证提供参考。Sweat is the manifestation of physiological function under the joint action of Yang Qi(阳气)and Yin(阴)fluid.If the sweat is abnormal,it is the sweating syndrome.The cause of sweating syndrome is often not a single factor,but the result of multiple factors intertwined and interacted with each other.The causes include externally-contracted six pathogenic factors,internal damage caused by the diet,emotional disorder,long-term illness and physical weakness,etc.In clinical practice,sweating syndrome can appear alone,showing its unique pathological characteristics and clinical manifestations,but also with many other diseases.The basic pathogenesis of sweating syndrome is the imbalance of Yin and Yang and the instability of interstices.Huangdi Neijing(《黄帝内经》)records:“Yang is added to Yin,which is called sweat.”indicating that sweat is the product of Yang transpiration Yin fluid from the interstices,the occurrence and development of sweat syndrome is closely related to Yin and Yang.Professor ZHANG Yongkang,based on the idea of“Yang is added to Yin,which is called sweat”,believes that Yin and Yang are the key line of sweating syndrome.Although the disease is complicated and changeable,deficiency and excess are mixed,starting from Yin and Yang can quickly grasp the pathogenesis and treat the syndrome differentiation.Clinically,patients with deficiency syndrome often have deficiency of Yin and Yang,Qi and blood,and cannot hold sweat.Patients with excess syndrome often suffer from liver fire,dampness and heat,and body fluid is forced out.We can also see the sweating syndrome caused by the disharmony between the Ying(营)and Wei(卫).Therefore,during treatment,deficiency syndrome need to be supplemented,excess syndrome need to be reduced,and disharmony between Ying and Wei need to be adjusted.The treatment methods include consolidating Yang Qi,nourishing Yin and reducing fire,tonifying Qi and nourishing blood,discharging heat and removing dampness,and harmonizing Ying and Wei.In the prescription,the Gu

关 键 词：汗证 阴阳 治疗经验 

分 类 号：R249[医药卫生—中医临床基础]