鲁明源运用升阳益胃汤经验

LU Mingyuan’s Experience on Using Shengyang Yiwei Decoction(升阳益胃汤)

鲁明源教授本于升阳益胃汤出处,将《脾胃论》与《黄帝内经》中的思想相结合,认为秉持辨证、辨天、辨人的思想,从病机特点、运气格局、体质基础等角度切入有助于深入理解其组方特点,掌握其证候表现。其中病机特点可从五脏、六经角度探讨:土不生金肺虚感邪、脾气不足郁热上熏、脾湿化热湿热蕴积、脾不升清肝阳郁遏导致中土不足五行失衡乃其五脏病机;本气先虚太少合病乃其六经病机。庚子年主运及四之气的运气格局,以及现代生活方式造就脾气虚的体质基础与升阳益胃汤的病机较为契合。基于病机特点、运气格局、体质基础剖析方药所适的证候表现可拓展其临床应用范围,从五脏、六经角度对方药进行分析,发现诸药相配可扶正祛邪,使五脏和调,六经畅达。在此基础上深入理解三辨合一的整体观念,可执简驭繁,灵活掌握升阳益胃汤的适用原则。

Based on the origin of Shengyang Yiwei Decoction(升阳益胃汤),Professor LU Mingyuan combines the ideas in the theory of spleen and stomach with the Internal Classic of the Yellow Emperor.He believes that adhering to the thought of syndrome differentiation,environment differentiation and human differentiation,and starting from the perspective of pathogenesis characteristics,patterns of five evolutive phases and six climatic changes and physical basis,it is helpful to deeply understand the characteristics of its formula and master its syndrome manifestations.The characteristics of pathogenesis can be discussed from the perspective of five Zang organs and six meridians:the soil does not produce the gold and the body is attacked by evils due to lung deficiency;insufficient spleen Qi causes heat depression in the upper,dampness in spleen transforms heat and the dampness and heat accumulate;spleen fails to make clear Qi ascend and liver Yang is obstructed,resulting in the imbalance of five elements of middle soil deficiency,which is the pathogenesis of five Zang organs.The pattern of five evolutive phases and six climatic changes in the year of Gengzi as well as the physical basis of spleen Qi deficiency created by modern lifestyle is more consistent with the pathogenesis of Shengyang Yiwei Decoction.Based on the characteristics of pathogenesis,the pattern of five evolutive phases and six climatic changes and the basis of physique,analyzing the syndrome manifestations suitable for prescriptions and drugs can expand the scope of their clinical application.Analyzing each other′s drugs from the perspective of five Zang organs and six meridians,it is found that the matching of various drugs can support the vital Qi and dispel the evil,make the five Zang organs harmonious and the six meridians unobstructed.On this basis,we can deeply understand the overall concept of three differentiation methods in one and flexibly grasp the applicable principles of Shengyang Yiwei Decoction.