论《内经》“脱营失精”

On Loss of Nutrition and Essence in The Yellow Emperor's Inner Classic

对《素问·疏五过论》"脱营失精"病名的由来、发病机制、与现代疾病的关系及其治疗进行论述。社会地位由高贵而后卑贱,由富有而后贫穷,人生处境由好转坏,内心产生极大落差,进而发展为"脱营"或"失精"。偏于"营阴(血)失脱"谓之"脱营",偏于"精气(液)失脱"谓之"失精"。病机可分虚实两端,虚者因精微化生不足,实者因郁火内扰;该病之初包含现代意义上的抑郁症,进一步加重则易形成癌症。治疗时,初期或抑郁症阶段,虚者治以补益五脏,实者治以解郁化火;加重形成癌症者,则应补虚与解毒相辅相成。此外,"脱营""失精"病包含情志因素,在治疗时应注意疏导患者的情绪,鼓励患者树立乐观豁达的心态才能取得良好的治疗效果。

The origin and mechanism and of loss of nutrition and essence in the chapter of Shu Wu Guo Lun from Basic Questions were reviewed and its relationship with the modem disease is discussed. The so- cial status of a person could be changed from the high to the low and vice versa,and such change will affect the mental state,resulting into loss of nutrition and even loss of essence. The former means the loss of nutrition and blood and the latter means the loss of essence,Qi and body fluids. The mechanism involves excess and deficiency. The deficiency is due to poor generation of essence,while the excess is caused by stagnant fire. Actually,it is similar to the depression of modern medicine,and it could further develop into tumor. For its treatment,in the early stage,the deficient type should be treated with tonifying viscera,and the excessive type should be treated with reliving depression and dispersing fire. For the cancer patient,it should be treated with tonifying and detoxication. Besides,loss of nutrition and essence involves the emotion factors,and therefore during the treatment,the patient should be encouraged to establish a positive mental state