论真寒假热之虚寒与实寒

Discuss Asthenia or Sthenia Cold of True Cold and False Heat

[目的]辨清真寒假热证之真寒的虚实属性,并简要总结。[方法]习读相关文献资料及理论书籍,分析、比较各医家主张,且从病因病机、临床症状、处方用药等几个方面全面论证真寒假热证之真寒的虚实属性。[结果]真寒假热证,从病因病机上说,是由于病程日久导致脾肾阳虚,阴寒邪气壅滞于体内,阳不化阴,使得阴阳不相顺接,从而将阳格拒于外,出现内真寒、外假热的病理状态;从临床症状上看,则表现为两颧泛红如妆、精神不振、畏寒蜷缩、四肢厥冷、口渴喜热饮、下利清谷、脉无力欲绝等一派虚寒之象;临床处方用药,则多为四逆汤类,其中君药为回阳救逆、大辛大热的附子、干姜,以去体内真寒之用。[结论]真寒假热证之真寒隶属于虚寒,无论是对疾病诊断还是临床救治,均具有一定的理论及现实意义。

Objective] Differentiate and analyse the asthenia or sthenia attribute about the cold attribute of true cold and pseudo hot syndrome, further to simply make a summary.[Method] In order to compare with other doctor’s viewpoint and prove the opinion from the etiology and pathogenesis, clinical symptoms, clinical application and so on, by researching the related literature and theoretical works.[Result]Pathological condition of inner true cold and outer false heat appears because Yang deficiency of spleen and kidney is so long that yin exopathogen is in stasis and yang fails to transport and transform ying, further to repel yang outside in the etiology and pathogenesis. Clinical symptoms show that the red zygomas looking like being made up, low spirit, coldblooded and huddling up body, chilly limbs, drinking much and hot, diarrhea with undigested food in the stool and extreme weak pulse and even no feelings. In clinical application, the prescription is sini tang and the main medicines are fuzi and ganjiang which restore yang and get rid of cold. [Conclusion]True cold and pseudo hot syndrome belongs to asthenia-cold. And no matter in disease diagnosis even in clinical treatment, it has an important theoretical and practical significance to distinguish and clear the asthenia or sthenia attribute.