基于脏气法时升降浮沉补泻理论论述脾胃不足

Discussion on deficiency of Piwei based on the theory of ascending-descending-floating-sinking and reinforcing-reducing in Zang-organs Qi correspond to nature rhythms

脏气法时升降浮沉补泻理论是李杲(号东垣)在《黄帝内经》《难经》等著作的基础上,汲取其师张元素关于药物有四气五味、分升降浮沉的思想,构建的脏腑补泻理论,是基于人与天地相应、五脏之气与四时五行相应,将四时、五行、五脏之气以及药物的气味相结合而形成的一套独特脏腑补泻理论体系,认为脾胃为五脏之本、升降枢纽、气血阴阳化生之源,而脾胃不足易致升降失常、阴火内生,甚至百病由生,重视脾胃在其中的作用,基于脏气法时升降浮沉补泻理论治疗脏腑疾病具有重要意义。此理论根据五行相生相克的规律,论述了五脏之气与四时之间的关系,提出五脏之气的运化均根据四时五行的观点。李杲在临证中格外重视脾胃之重要作用,认为人以脾胃为本,内伤脾胃,百病由生,根据脾胃之生理特性、病理特点,配合药物气味之升降浮沉,并随时进行加减。文章结合案例,以脏气法时升降浮沉补泻理论为指导,论述脾胃对于机体的重要性、脾胃不足对机体的影响,探析脾胃不足的治疗原则。

On the basis of Huangdi Neijng(《黄帝内经》)and Nanjing(《难经》),LI Gao learned from his teacher ZHANG Yuansu's idea that drugs have four Qi(气)and five flavors,lifting and lowering.Theory of lifting,lowering,floating,sinking,reinforcing,reducing in Zang-organs Qi correspond to nature rhythms is constructed,which is the theory for tonifying and reducing viscera.This theory combines the theory of human-environmental inter relation,the Qi of the five Zang(五脏)organs and four seasons and five elements.He believes that spleen and stomach is the foundation of five Zang-organs,the hub of lifting and lowering,and the source of Qi and blood Yin(阴)and Yang(阳)transformation,while the deficiency of spleen and stomach can easily lead to the disorder of lifting and lowering,endogenesis of Yin and fire,and even diseases.Pay attention to the spleen and stomach,it is of great significance to treat viscera diseases based on the theory of lifting,lowering,floating,sinking,reinforcing,reducing in Zang-organs Qi correspond to nature rhythms.According to the law of five elements counteract each other,this theory discusses the relationship between the Qi of the five Zang organs and the four seasons,and puts forward the view that the transportation and transformation of the the Qi of the five Zang organs are based on four seasons and five elements.LI Gao attaches importance to spleen and stomach during treatment,and believes that spleen and stomach is material basis,all diseases are due to internal injuries of spleen and stomach.According to the physiological and pathological characteristics of spleen and stomach,combined with the lift,lower,float,sink of Chinese materia medica,the composition of medicines in the prescription is changed at any time.Combined with the case,the importance of spleen and stomach to the body is discussed,and the therapeutic principle of spleen and stomach deficiency and its effect on the body were analyzed,based on theory of lifting,lowering,floating,sinking,reinforcing,reducing in Zang-organs Qi correspond to nature rhythms.