缪希雍基于“龙虎回环”理论治疗泄泻  

Miao Xiyong′s Experience in Treating Diarrhea Based on the Theory of "Dragon and Tiger Circulation"

作　　者：梁瑶 李定祥 LIANG Yao;LI Dingxiang(The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China,410021)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410021

出　　处：《河南中医》2025年第4期523-527,共5页Henan Traditional Chinese Medicine

基　　金：湖南省科技创新团队项目(2020RC4050)。

摘　　要：缪希雍基于“龙虎回环”理论认为,肝居于左主升,肺居于右主降,脾胃居于中焦,为气机升降之枢纽,肝肺气机失常是泄泻的重要病机,治泄时宜升在治肝、降在治肺、肝肺同治。肝气失常者以风药发散升举之,常用药物有升麻、柴胡、川芎等;但若“木旺乘土”或“土虚木乘”,法宜制肝实脾,方用痛泻要方。肺气失常者以酸收敛肃之,药选白芍药、桑白皮、五味子等;若泄泻为脾土受风寒湿热之邪困阻所致而脾气不虚者,可用“实则泻其子”法止泻,药用藿香、紫苏子、车前子等。肝肺失常者,肝肺同治,常以提壶揭盖法宣肺或以升提之药通利小便以达到“利小便、实大便”之功,药用桔梗、麻黄、前胡等;湿邪易流注于三焦,治当宣通三焦,方用三仁汤。Based on the theory of "dragon and tiger circulation",Miao Xiyong believed that the liver,located on the left,mainly ascends,while the lung,located on the right,mainly descends,forming a circuit of qi movement.The spleen and stomach,situated in the middle energizer,serve as the pivot for the ascending and descending of qi movement.Abnormal liver and lung qi movement is an important pathogenesis of diarrhea.When treating diarrhea,it is advisable to ascend in treating the liver,descend in treating the lung,and treat both the liver and lung simultaneously.For those with abnormal liver qi,wind drugs for dispersing and ascending are used,such as Shengma(Rhizoma Cimicifugae),Chaihu(Radix Bupleuri),Chuanxiong(Rhizoma Chuanxiong),etc.However,if there is "exuberant wood overrestricting earth " or "wood overrestricting asthenic earth",the method of regulating the liver and strengthening the spleen should be adopted,so Important Formula for Painful Diarrhea can be used.For those with abnormal lung qi,sour-tasting medicinals that astringe and calm are selected,such as Baishaoyao(Radix Paeoniae Alba),Sangbaipi(Cortex Mori),Wuweizi(Fructus Schisandrae Chinensis),etc.If the spleen earth is obstructed by wind,cold,dampness and heat,causing diarrhea,but the spleen qi is not deficient,the method of "purging or reducing it in a case of excess" can be used to stop the diarrhea.Medicinalss such as Huoxiang(Herba Pogo Stemonis),Zisuzi(Fructus Perillae),Cheqianzi(Semen Plantaginis),etc.can be used.For those with liver-lung disharmony,both organs should be treated simultaneously.The method of "lifting the pot and removing the lid" is often employed,either by ventilating the lung or using ascending and draining medicinals to facilitate urination,achieving the effect of "promoting urination and solidifying the stool".Medicinals such as Jiegeng(Radix Platycodonis),Mahuang(Herba Ephedrae),Qianhu(Radix Peucedani),etc.are commonly used.Since dampness tends to flow through the triple energizer,treatment should focus on promoting the free flow

关 键 词：泄泻 “龙虎回环”理论 肝升肺降 风药 缪希雍 

分 类 号：R256.34[医药卫生—中医内科学]