《内外伤辨惑论》“从里治外感”思想探析

Analysis of "Treating External Affection from Inside" Thought in Nei Wai Shang Bian Huo Lun

外感病并不只表现为表证,当其脾胃已伤除表现为表里同病外,纯里无表者亦多见。脾胃内伤不足以卫外,外邪直趋而入,不在表停留而直中于里,表现为里证,治疗当纯从里证入手即可。笔者通过分析《内外伤辨惑论》中补中益气汤方证、当归补血汤方证和李东垣清暑益气汤方证,发现此三方均可用于治疗外感病,但治法专于补脾胃之气。李东垣从调补正气出发,以“正气充盛,邪气乃消”为主要思想治疗太阴里虚外感证,对外感病的施治论治提供了新的理论指导。

Exogenous disease is not only manifested as the exterior syndrome, when the spleen and stomach have been injured, in addition to the performance of the exterior with the disease, interior syndrome is also more common.The internal injury of spleen and stomach is not enough to protect the outside, and the external evil is directed to the inside, not to stay in the exterior but to the inside, which is manifested as the inside syndrome. The treatment should only start from internal syndrome. Through the analysis of the syndrome of Buzhong Yiqi decoction, the syndrome of Danggui Buxue decoction and the syndrome of Dongyuan Qingshu Yiqi decoction in Nei Wai Shang Bian Huo Lun, the author found that these three prescriptions can be used to treat exogenous diseases, but the treatment method is only for tonifying Qi in the spleen and stomach.Starting from regulating and replenishing the vital Qi, dongyuan treated the syndrome of external infection with the main idea of "filling the vital Qi and eliminating the evil Qi", which provided a new theoretical guidance for the treatment of external diseases.