“邪之所在,皆为不足”探析  

Exploration of"Where There is Evil Factor,There Is Deficiency"

作　　者：吴俊哲 蔡卓昊 刘朋 田露[1,2] WU Junzhe;CAI Zhuohao;LIU Peng;TIAN Lu(Tianjin University of Traditional Chinese Medicine,Tianjin China 301617;Guo Aichun′s Institute of Medical History and Literature,Tianjin University of Traditional Chinese Medicine,Tianjin China 301617)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学郭霭春医史文献研究所,天津301617

出　　处：《中医学报》2025年第5期1000-1004,共5页Acta Chinese Medicine

基　　金：国家中医药管理局科研基金项目(GZY-KJS-2021-061);天津市科委基金项目(ZX2021021)。

摘　　要：“邪之所在,皆为不足”首见于《黄帝内经》,该条文不仅有“邪之所凑,其气必虚”的理论内涵,并在更高层面上表现了正邪关系变化导致正气“相对不足”“绝对不足”的病理状态对疾病发病的不同影响。“邪之所在,皆为不足”易导致由“上气不足”“中气不足”“下气不足”所主导的三类疾病发生。其中,“上气不足”以“脑为之不满”为因,导致出现以虚性表现为主的疾病,即“耳为之苦鸣”“头为之苦倾”“目为之眩”,治疗以补益正气、升举清阳为治疗大法,使正气得养,清阳得展,则病邪自除;若见“中气不足”,机体无力祛邪于外,则发为二便不利、肠鸣腹痛等证,治宜补中益气,可用补中益气汤、黄芪建中汤、四君子汤等方剂加减治疗;由“下气不足”所致如痿厥、心悗等病证,当责之于肾,当以补肾益气、填精益髓为治疗大法,使心肾得交,水火既济,临证可用虎潜丸、交泰丸等方剂加减化裁。The throry that"Where there is Evil Factor there is deficiency"was first proposed in Huang Di Nei Jing,which not only has the theoretical connotation of"where there is Evil Factor there is Qi deficiency",but also expresses at a higher level the effect of the"relative insufficiency"and"absolute insufficiency"of Zheng Qi due to the changes in relationship between Zheng Qi and Evil Factor Qi on the onset of different diseases."Wherever there is Evil Factor there is deficiency,"which can easily lead to the occurrence of three types of diseases dominated dominated by"upper Qi deficiency","middle Qi deficiency"and"lower Qi deficiency".Among them,"insufficiency of upper Qi"is caused by"deficiency of the brain",which leads to the emergence of illnesses with deficiency manifestations,i.e.,"noisy ringing in the ears","bitter tilting of the head",and"dizziness of eyes".The treatment is to replenish the Zheng Qi and raise the clear Yang,so that the positive Zheng Qi can be nourished and the clear Yang can be developed,then the disease and the Evil factors will be removed;if there is a lack of"middle Qi"and the body is unable to expel the Evil factors,then the disease will be characterized as difficulty in urination and defecation,intestinal sounding and abdominal pain,etc.,the treatment is appropriate to replenish the middle Qi.Modified Buzhong Yiqi Decoction,Huangqi Jianzhong Decoction,Sijunzi Decoction and other formulas can be used in treatment;as for the"lower Qi insufficiency"such as Wei syndrome and Jue syndrome,the Kidney is responsible.The treatment should be tonifying Kidney and benefiting qi,filling the Essence and tonifying the marrow,as so to balance the Water and Fire,and modified Huqian Pill and Jiaotai Pill can be used in treatment.

关 键 词：“邪之所在 皆为不足” 上气不足 中气不足 下气不足 《黄帝内经》 

分 类 号：R221.09[医药卫生—中医基础理论]