李东垣《脾胃论》“阴火”理论探讨

Discussion on ‘yin fire’ theory of Treatise on Spleen and Stomach of LI Dong-yuan

"阴火"理论是李东垣"脾胃学说"的核心,其基本内容均见于李东垣撰著的《脾胃论》中。因李东垣对"阴火"的概念和病机阐述不甚明确,因此后世对"阴火"的理解也各不相同,且至今莫衷一是。笔者通过对《脾胃论》的深入研究,认为"阴火"其实质是脾胃内伤虚损所产生的一种火热邪气。"阴火"产生的基本病机是内伤脾胃,脾胃气虚,清阳不升。故"阴火"治疗以"益气升阳""甘温除热"为主法,若阴火亢盛,可加少量泻火药为从权施治之计。

Theory of ‘yin fire＇ is the core of ＇theory of spleen and stomach＇ proposed by LI Dong-yuan, its basic content is all in the book of Treatise on Spleen and Stomach written by LI Dong-yuan. Later generations are also different in the understanding of‘yin fire＇ because LI Dong-yuan＇s conception and pathogenesis of‘yin fire＇ are not very clear, and so far there is no consensus. Through in-depth study of Treatise on Spleen and Stomach, the authors think that the essence of‘yin fire＇ is a kind of fiery evil which is produced by the deficiency of internal injury of spleen and stomach. The basic pathogenies of ‘yin fire＇ is internal injury of spleen and stomach, deficiency of spleen and stomach qi, qingyang is not ascending. Therefore, the treatment of ‘yin fire＇ is mainly based on‘benefiting qi and raising yang＇, ‘relieving fever with sweet and warm drugs＇, if ‘yin fire＇ is excessive, a small amount of fire-purging drugs can be added for the treatment of power.