基于“阴阳水火气血论”探讨下肢静脉性水肿的证治  

Discussion on the pattern differentiation and treatment of lower limb venous edema based on the Theory of Yin, Yang, Water, Fire, Qi, and Blood

作　　者：余清璇 谢存香 张艳 杨剑锋 张力睿 李友山[1] YU Qingxuan;XIE Cunxiang;ZHANG Yan;YANG Jianfeng;ZHANG Lirui;LI Youshan(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《现代中医临床》2025年第2期56-59,69,共5页Modern Chinese Clinical Medicine

基　　金：北京中医药大学东直门医院三明工程教学类资助基金(No.405120414)。

摘　　要：下肢静脉性水肿是下肢静脉疾病中最常见且较为难治的一种疾病,西医治疗存在较大困难,本文基于《血证论》中“阴阳水火气血论”,探讨下肢静脉性水肿的病因病机及诊治思路。人体的一切生理活动都是阴阳二气不断运动的结果,水火气血可相互转化,在生理与病理上都有密切联系。治疗下肢静脉性水肿需要掌握气血水火之间的生理病理关系,从而灵活调和阴阳气血水火的生化运行。气病水病、瘀血化水为本病基本病机,治疗应以益气、活血、调脾为基础,更应重视养阴药的运用,以水化气、以津养血,充盈脉道,促进血液恢复正常运行。结合临床病例对基于“阴阳水火气血论”探讨下肢静脉性水肿的证治进行介绍。Lower extremity venous edema is one of the most common and difficult-to-treat diseases in lower extremity venous diseases, Western medicine and there are great problems in its treatment. This article explores the etiology, pathogenesis, and treatment approach of lower limb venous edema based on the “Theory of Yin, Yang, Water, Fire, Qi, and Blood” from the work Xue Zheng Lun(Treatise on Blood Syndromes). All physiological activities in the human body result from the continuous movement of yin and yang. Water, fire, qi, and blood can interconvert, and they are closely linked in both physiological and pathological processes. The treatment of lower limb venous edema requires understanding the physiological and pathological relationships among qi, blood, water, and fire, so as to flexibly regulate the movement of yin, yang, qi, blood, water, and fire. The basic pathogenesis of this disease involves qi stagnation, water retention, and blood stasis transforming into water. Treatment should focus on tonifying qi, invigorating blood, and regulating the spleen. Additionally, the use of yin-nourishing herbs is essential to transform water into qi, nourish the blood with body fluids, and fill the vessels, promoting normal blood circulation. Clinical cases are presented to illustrate the syndrome differentiation and treatment of lower limb venous edema based on the theory of Yin, Yang, Water, Fire, Qi, and Blood.

关 键 词：下肢静脉性水肿 阴阳水火气血论 瘀血化水 

分 类 号：R268[医药卫生—中医外科学]