从脏腑风湿论探析“寒热错杂本质是寒”的内涵和临床应用  

Connotation and Clinical Application of"The Nature of Cold and Heat Complex Syndrome is Cold":from the Perspective of Zang-Fu(脏腑)Wind-Damp Theory

作　　者：林潼 杨映映 赵林华[1] 张莉莉[1] LIN Tong;YANG Yingying;ZHAO Linhua;ZHANG Lili(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;China-Japan Friendship Hospital)

机构地区：[1]中国中医科学院广安门医院,北京市100053 [2]中日友好医院

出　　处：《中医杂志》2025年第8期795-799,共5页Journal of Traditional Chinese Medicine

基　　金：北京市自然科学基金(7244497);中央级公益性科研院所基本科研业务费专项资金(ZZ16-XRZ-042);中国中医科学院科技创新工程创新团队(CI2021B008);中国中医科学院广安门医院临床医学研究中心建设专项(2022LYJSZX28);中华中医药学会(2023-2025年度)青年人才托举工程项目(CACM-2023-QNRC2-A08);中国中医科学院广安门医院护航工程(骨干人才培养项目)(GAMHH9324025);国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)。

摘　　要：脏腑风湿论认为,风寒湿邪气内伏,郁而化热,伏于脏腑而成痼疾,热为表象,寒为病因,每遇外感引动伏邪,则脏腑病加重或反复发作,多表现为寒热错杂的复杂证候。基于脏腑风湿论提出“寒热错杂本质是寒”的学术观点,认为对于病机为寒热错杂的疾病,外感风寒湿为始动因素,发作期治疗以祛邪、透邪为要,使风寒湿宿邪外出,缓解期扶正培本,寒湿得蠲。内湿源于脾,故调理脾胃、散寒除湿是治疗脏腑风湿病的大法。寒湿俱为阴邪,易伤阳气,且风寒湿邪反复侵袭,闭阻脏腑气机,阳气渐损,因此治疗上还需顾护阳气,温阳以散寒湿。“寒热错杂本质是寒”为中医理论的临床应用与疑难复杂病的中医诊治提供了思路。According to zang-fu(脏腑)wind-damp theory,it is believed that wind,cold,and dampness are internal pathogenic factors that,when stagnated,transform into heat and invade the zang-fu organs,leading to chronic conditions.Heat is seen as a manifestation,while cold is considered the root cause.When external factors trigger these latent pathogens,the disease of the zang-fu organs exacerbates or relapses,often presenting with a complex syndrome of cold and heat.Based on this theory,the viewpoint of"for complex syndrome of cold and heat,cold is the root"is proposed.It suggests that for diseases with a complex cold-heat syndrome,external invasion of wind,cold,and dampness are the initiating factors.During the acute phase,treatment should focus on dispelling and eliminating the pathogens to promote the expulsion of the latent wind,cold,and dampness.During the remission phase,the focus shifts to reinforcing the healthy qi and tonifying the root,allowing the cold and dampness to be cleared.Internal dampness originates from the spleen;therefore,regulating the spleen and stomach,and dispersing cold and removing dampness is the key to treating wind-damp disorders of zang-fu organs.Cold and dampness are both yin pathogens,which damage yang qi,and repeated invasions of wind,cold,and dampness obstruct the qi flow of the zang-fu organs,progressively weakening yang qi.Hence,it is necessary to protect yang qi,and thereafter dispelling cold and dampness by warming yang.The theory that"for complex syndrome of cold and heat,cold is the root"provides guidance for the clinical application and the treatment of complex and difficult diseases in traditional Chinese medicine.

关 键 词：寒热错杂 脏腑风湿论 散寒除湿 

分 类 号：R255.6[医药卫生—中医内科学]