基于圆运动的五行理论探讨补中益气汤治疗气虚发热的机制(1)
[摘要] 五行五脏之间存在着巧妙的升降关系，《圆运动的古中医学》作者彭子益将这种人体正常的五行升降关系总结为“左升右降，四维如轮，中央为轴”。补中益气汤是李东垣创立的治疗饮食劳倦、内伤中热证的方剂，后世尊其为治疗气虚发热之代表方，但对其治疗机制众说纷纭，未有定论。基于圆运动的五行理论，笔者认为补中益气汤能治疗气虚发热的机制在于纠正了阳气“左降右升”的运行错误，恢复了阳气“左升右降”的正常运行规律。
[关键词] 圆运动；五行理论；补中益气汤；气虚发热；左升右降
[中图分类号] R22 [文献标识码] A [文章编号] 1673-7210(2016)12(a)-0118-04
The mechanism of Buzhong Yiqi Decoction in the treatment of fever due to qi deficiency based on five phases theory of circular motion
LIANG Rui1 HUANG Shuang2 KUI Yu3
1.Department of Pediatrics， the First Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510405， China； 2.Department of Gynecology， the Second Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510120， China； 3.Department of Traditional Therapy， the Second Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510120， China
[Abstract] The five phases and five zang viscera have ingenious relationship of lifting and lowering. Peng Ziyi， the author of The Ancient Chinese Medicine of Circular Motion， summarizes the normal relationship of lifting and lowering of five phases as “lifting left and lowering right， four dimensions as the wheel， center as axis”. Buzhong Yiqi Decoction founded by Li Dongyuan is used for treating diet and overstrain and internal heat damage， which is known as representative prescription for treating fever due to qi deficiency， but the mechanism of Buzhong Yiqi Decoction is inconclusive. Based on five phases theory of circular motion， the author thinks that， the mechanism of Buzhong Yiqi Decoction for treating fever due to qi deficiency lies in correcting the run-time error of “lowering left and lifting right” of yang qi， recovering the law of normal running of “lifting left and lowering right” of yang qi.
[Key words] Circular motion； Five phases theory； Buzhong Yiqi Decoction； Fever due to qi deficiency； Lifting left and lowering right
自李東垣创立补中益气汤治疗劳倦内伤中热之证以来，中医界均公认补中益气汤为治疗气虚发热的代表方剂。但对于其治疗的思路以及机制却众说纷纭，没有定论。遗憾的是李东垣本人在著作中对此的描述晦奥难明，如其在《脾胃论》中提及“若饮食失节，寒温不适，则脾胃乃伤；喜、怒、忧、恐，损耗元气。既脾胃气衰，元气不足，则心火独盛，心火者，阴火也，起于下焦，其系系于心，心不主令，相火代之；相火，下焦包络之火，元气之贼也。火与元气不两立，一胜则一负。脾胃气虚，则下流于肾，阴火得以乘其土位。此段文字是李东垣集中论述气虚发热的机制，其中脾胃气虚是发病的基础，这点得到公认，但脾胃气虚如何进一步导致发热，李东垣从“阴火”“相火”“火与元气不两立”“阴火下乘土位”等方面论述，但交代欠于清晰，故引起历代医家的争论，也导致医者的困惑，对如何使用补中益气汤治疗发热疾病拿捏不准。笔者从李东垣原著入手，分析其学术形成的时代背景、所列举病症的典型表现，结合圆运动的五行升降理论，对补中益气汤治疗气虚发热的机制做出大胆的探讨，希望能溯本求源，明示理论，解答这一中医学术界之“疑问”，并对中医临床提供更好的理论支持。, http://www.100md.com(梁锐 黄爽 奎瑜)
[关键词] 圆运动；五行理论；补中益气汤；气虚发热；左升右降
[中图分类号] R22 [文献标识码] A [文章编号] 1673-7210(2016)12(a)-0118-04
The mechanism of Buzhong Yiqi Decoction in the treatment of fever due to qi deficiency based on five phases theory of circular motion
LIANG Rui1 HUANG Shuang2 KUI Yu3
1.Department of Pediatrics， the First Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510405， China； 2.Department of Gynecology， the Second Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510120， China； 3.Department of Traditional Therapy， the Second Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Province， Guangzhou 510120， China
[Abstract] The five phases and five zang viscera have ingenious relationship of lifting and lowering. Peng Ziyi， the author of The Ancient Chinese Medicine of Circular Motion， summarizes the normal relationship of lifting and lowering of five phases as “lifting left and lowering right， four dimensions as the wheel， center as axis”. Buzhong Yiqi Decoction founded by Li Dongyuan is used for treating diet and overstrain and internal heat damage， which is known as representative prescription for treating fever due to qi deficiency， but the mechanism of Buzhong Yiqi Decoction is inconclusive. Based on five phases theory of circular motion， the author thinks that， the mechanism of Buzhong Yiqi Decoction for treating fever due to qi deficiency lies in correcting the run-time error of “lowering left and lifting right” of yang qi， recovering the law of normal running of “lifting left and lowering right” of yang qi.
[Key words] Circular motion； Five phases theory； Buzhong Yiqi Decoction； Fever due to qi deficiency； Lifting left and lowering right
自李東垣创立补中益气汤治疗劳倦内伤中热之证以来，中医界均公认补中益气汤为治疗气虚发热的代表方剂。但对于其治疗的思路以及机制却众说纷纭，没有定论。遗憾的是李东垣本人在著作中对此的描述晦奥难明，如其在《脾胃论》中提及“若饮食失节，寒温不适，则脾胃乃伤；喜、怒、忧、恐，损耗元气。既脾胃气衰，元气不足，则心火独盛，心火者，阴火也，起于下焦，其系系于心，心不主令，相火代之；相火，下焦包络之火，元气之贼也。火与元气不两立，一胜则一负。脾胃气虚，则下流于肾，阴火得以乘其土位。此段文字是李东垣集中论述气虚发热的机制，其中脾胃气虚是发病的基础，这点得到公认，但脾胃气虚如何进一步导致发热，李东垣从“阴火”“相火”“火与元气不两立”“阴火下乘土位”等方面论述，但交代欠于清晰，故引起历代医家的争论，也导致医者的困惑，对如何使用补中益气汤治疗发热疾病拿捏不准。笔者从李东垣原著入手，分析其学术形成的时代背景、所列举病症的典型表现，结合圆运动的五行升降理论，对补中益气汤治疗气虚发热的机制做出大胆的探讨，希望能溯本求源，明示理论，解答这一中医学术界之“疑问”，并对中医临床提供更好的理论支持。, http://www.100md.com(梁锐 黄爽 奎瑜)