“以脾为本,五脏相关”的李东垣“阴火理论”

Analysis of LI Dongyuan's"Yin Fire Theory"Based on Thought of"Spleen Being Root and Five Zang-organs Related"

李东垣著《脾胃论》,创泻阴火名方,立阴火学说,为后世丰富了“甘温除大热”的认识。针对阴火,诸多医家立论探讨其病因病机。虽然阴火的发病机制仍存争议,但脾土亏虚是阴火发病的基础被广泛认同。东垣重视脾胃,同时亦注重脾与其余各脏间的相互联系,这与当今所提出的“以脾为本,五脏相关”理论有着异曲同工之妙。因此,结合医籍文献及现代研究,基于“以脾为本,五脏相关”的思想探析阴火发生的病因病机,阐释阴火多种表现形式的形成机制,论述阴火与阳火的区别与联系,总结泻阴火的三种方法。另外,选取两例阴火病治验案以协助理解及运用阴火理论。这或将有利于医者深入认识阴火和灵活运用阴火理论。

LI Dongyuan wrote the Theory of Spleen and Stomach,created the prescription to eliminate Yin Fire,established the theory of Yin fire and enriched the understanding of"relieving high fever with drugs of sweet flavour and warm nature"for later generations.The etiology and pathogenesis of Yin fire were discussed by many doctors.Though it is still controversial to discuss the etiology and pathogenesis of Yin fire,the deficiency of spleen is widely recognized as the basic mechanism of Yin fire.LI Dongyuan attached importance to the spleen and stomach,and also paid attention to the relationship between the spleen and the other Zang-organs.This thought is similar to the theory of"spleen being the root and five Zang-organs related",which was put forward today.Therefore,based on the thought of"spleen being the root and five Zang-organs related",the author combined traditional literature and modern research to explore the etiology and pathogenesis of Yin fire,explained formation mechanism of various forms of Yin fire,discussed the difference and connection between Yin fire and Yang fire,and summarized three methods of treating Yin fire.In addition,the author selected two successful cases of Yin fire disease treatment to help understand and apply the theory of Yin fire.This may be helpful for doctors to have a deep understanding of Yin fire,and it would also be helpful for doctors to flexibly apply the theory of Yin fire.