李东垣与黄元御调治脾胃升降治则治法分析

Analysis of Therapeutic Principles and Methods of Li Dongyuan and Huang Yuanyu in Regulating the Ascending and Descending of Spleen and Stomach

李东垣调治脾胃升降注重调治脾胃自身虚实,结合四时及诸多具体病因及继发病邪,精细灵活施治。治则以补脾胃升清阳扶正为本,应时令祛邪降浊为标。核心治法为补中升阳,其他治法有降火、利湿、降浊、滋阴、补血、活血、理气、解表等。黄元御通过调治中气而恢复脾胃自身升降,诸病得愈。忽略脾胃自身虚实,不借助外力,针对核心病机(水寒土湿),执简驭繁。治则为轴运轮转,阴阳气血各归其位,转邪为正。核心治法为暖水燥土、升脾降胃。其他有降肺、清肺、敛胆、达肝、滋肝、泻肝、清心、温肾等。

Li Dongyuan paid attention to the deficiency and excess of the spleen and stomach,combined with the four seasons and many specific causes and secondary pathogenic factors.The principle of treatment is to tonify the spleen and stomach,raise the level of yang,and strengthen the body.The core treatment is to invigorate the middle and raise the yang.Other treatments include reducing fire,promoting dampness,reducing turbidity,nourishing yin,tonifying blood,activating blood,regulating qi,relieving exterior and so on.Huang Yuanyu recovered the spleen and stomach by regulating the middle qi.Ignoring the deficiency and excess of the spleen and stomach itself,without the help of external forces,aiming at the core pathogenesis(water cold and soil wet),we should keep simple and control the complex.The treatment principle is the rotation of the axis,yin and yang,qi and blood return to their respective positions and turn evil into positive.The core treatment is warm water and dry soil,ascending spleen and descending stomach.Others are descending lung,clearing lung,astringing gallbladder,reaching liver,nourishing liver,purging liver,clearing heart,warming kidney,etc.