李杲学术思想之“脾胃兼化”方证述要  

Li Gao′s Academic Thought of"Spleen and Stomach Jian Hua"in Syndrome and Prescription

作　　者：徐畅 孙鸿昌[1] 徐亚民 张怀亮[3] XU Chang;SUN Hongchang;XU Yamin;ZHANG Huailiang(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;Traditional Chinese Medicine Hospital of Xuchang,Xuchang Henan China 461000;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学,河南郑州450046 [2]许昌中医院,河南许昌461000 [3]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2025年第5期970-975,共6页Acta Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目{国中药人教函〔2018〕134号}。

摘　　要：“兼化”最早由刘完素提出,是指两邪或三邪相合而出现的病理现象。李东垣作为易水学派大家,深受刘完素影响,以《难经》的“五邪相干”为理论指导,在长期的医疗实践中认识到脾胃不足则变证丛生,提出了“心之脾胃虚”“肝之脾胃虚”“肺之脾胃虚”“肾之脾胃虚”四种兼化病模式。“脾胃兼化”证理论基础为内生五邪,兼化为病;脉象表现为他脏所主脉象,故切脉问症可知病从何来。李东垣在治疗脾胃虚弱与他脏相兼所致疾病时,始终以升发阳气、顾护脾胃为治疗原则。The term of"Jian Hua",which was firstly proposed by Liu Wansu,refers to the pathological phenomenon that occurs when two or three evil factors are combined.Li Dongyuan,as a member of the Yishui school,was deeply influenced by Liu Wansu.Li took the"mutual interference of five evil factors",which was proposed in Nan Jing,as his theoretical guide.In his long-term medical practice,he realized that the deficiency of the Spleen and Stomach would lead to a series of changes and syndromes,and put forward four modes of concurrent disease,namely,"deficiency of Spleen and Stomach caused by Heart""deficiency of Spleen and Stomach caused by Liver""deficiency of Spleen and Stomach caused by Lung"and"deficiency of Spleen and Stomach caused by Kidney".The theoretical basis of"Spleen and Stomach Jian Hua"is that five evil factors,which are generated internally,lead to concurrent disease;the pulse manifests the main pulse of the other Zang,so by feeling the pulse and asking about the symptoms where the disease comes from can be worked out.When treating diseases caused by the combination of Spleen and Stomach weakness with other Zang,Li Dongyuan always took the principle of promoting Yang Qi and protecting Spleen and Stomach as the treatment principle.

关 键 词：“脾胃兼化” 心之脾胃虚 肝之脾胃虚 肺之脾胃虚 肾之脾胃虚 李杲 刘完素 

分 类 号：R256.3[医药卫生—中医内科学]