金元四大家从“火”论消渴病机理论研究

Four Medical Schools in Jin-Yuan Dynasty Expound Diabetes Pathogenesis from Theory of “Fire”

金元四大家均把＂火＂看作消渴病发生、发展过程中的重要病理因素,密切影响消渴病传变。基于玄府气液学说,刘完素从＂火热怫郁＂论消渴,并重视五运六气影响;张从正遵从＂三消当从火断＂之说,同时指出心火的传变规律;李东垣依据＂内伤脾胃-元气亏虚-血虚津亏-血中伏火＂层次理论,把阴火致消作为主要病机;朱丹溪从＂阳有余、阴不足＂出发,认为＂相火妄动＂是引发消渴的关键。四大学派所论消渴火热病机,各具特点,又相互联系,丰富了消渴理论框架体系,启发现代中医对于消渴病机的重新认识、学术理论的不断完善,为中医药发展注入新活力。

The four medical schools in Jin-Yuan Dynasty regarded＂fire＂as the important pathological factor of occurrence and development in diabetes. The ＂fire＂closely affects the diabetic changes. Basing on pore and Qi-fluid theory,LIU Wansu discussed diabetes from the theory of＂fire and heat depression＂,and payed attention to＂five elements and six pathogens＂theory. According to ＂three Xiao distinguished from fire＂,ZHANG Congzheng pointed out the changing law of heart fire. Basing on the theory of ＂internal-injured spleen-stomach to promordial Qi deficiency to blood deficiency and depleted fluid to latent fire in blood＂,LI Dongyuan treated Yin-Fire as the main pathogenesis of diabetes. Proceeding from＂Yang often being much,Yin often deficiency＂,ZHU Danxi thought hperactivity of vital cate fire can cause diabetes. The four academic schools featured the different characteristic of diabetic＂fire and heat＂pathogenesis,but they connected with each other,riching the theoretical framework of diabetes. Traditional Chinese medicine scholars should further study diabetic pathogenesis and improve the academic theory,which can inject vigour into the development of TCM.