“一气周流”理论临床应用

Clinical Application of the Theory of"Circumfluence at a Stretch"

“一气周流”理论认为,中土为气机升降枢纽和全身气化基础,中土之气通过气机的升降浮沉带动四象之气的转运,循环往复,贯通全身,形成“一气周流”的循环状态。疾病的形成有3种原因,第一,左路肝木之阳升散太过,或右路阴金潜降不及,发为阳盛之热病,或阴虚之热病;第二,左路之肝木升发不及,或右路肺金潜降太过,发为阴盛则寒病,或阳虚则寒病;第三,中土发病,致使升降枢纽不利,治疗应以“扶阳崇阳、培土利枢、统经四象”为原则。甲状腺相关性眼病病机为“脾失健运、肝木郁滞、肺金不利、肾水寒瘀”,用四君子汤合二陈汤加减健运中气,行水化气,逼邪外出。心力衰竭病机为水寒土湿,治当以顾护中气为主,用人参、干姜燥土暖水,甘草、茯苓培土利水。历节病病机为肾水寒不能温肝木,肝生血不足而致血虚,再加外感之邪侵袭,当治以温化寒湿为主,方用桂枝芍药知母汤加减。口疮病机为气机郁滞不通,涩滞于中焦,治当顾护脾胃,宣畅中焦,方用平胃散加生姜、大枣等。健运中土,推动左右旋转,则气能周流,御气祛邪,阴平阳秘。

According to the theory of"circumfluence at a stretch",the middle earth is the ascending-descending hub of qi movement and the qi transformation foundation of the whole body.The qi of the middle earth drives the transfer of the four images of the qi through the ascending,descending,floating and sinking,which circulates and penetrates the whole body,forming a cyclic state of"circumfluence at a stretch".There are three reasons for the formation of the disease.First,the yang rising of the left liver wood is too much,or the yin of the right lung metal can not descend,then there wil be yang excess transforming heat disease,or yin deficiency transforming heat dis-ease.Second,the liver wood on the left fails to disperse,or the lung gold on the right descends too much,then there will be yin excess transforming cold disease,or yang deficiency transforming cold disease.Third,middle-earth disease results in unfavorable ascending-de-scending hub,so treatment should be based on the principle of"reinforcing yang,banking up earth to help the hub,and controlling the four images."The pathogenesis of thyroid-associated eye disease is"the spleen failing to function,liver wood depression,lung metal's dysfunction,and kidney water cold leading to stasis",so Modified Four Gentlemen Decoction combined with Two Matured Substances Decoction can be adopted to activate qi of the middle energizer,move water and drive qi and remove pathogens out.The pathogenesis of heart failure is"cold water and wet earth",the treatment should focus on protecting qi of the middle energizer,so Renshen(Radix Gin-seng)and Ganjiang(Rhizoma Zingiberis)are used to dry earth and warm water;Gancao(Radix Glycyrrhizae)and Fuling(Poria)are used to bank up earth and induce diuresis.The pathogenesis of multiple arthralgia disease is that cold kidney water can not warm liver wood,so the liver can not generate enough blood resulting in blood deficiency;Besides,the invasion of exogenous pathogens is another factor.The treatment should focus on warming cold dampness,so Modified Cinnamon Twig and Peony and Rhizoma Anemarrhenae De-coction can be used.The pathogenesis of aphthae is qi stagnation blocking in the middle energizer,the treatment should focus on protec-ting the spleen and stomach,dispersing the middle energizer,so Stomach-Calming Powder plus Shengjiang(Rhizoma Zingiveris Recens)and Dazao(Fructus Jujubae)etc.can be used.Reinforcing the middle earth,promoting the rotation of the left and right,then qi can flow around to remove pathogens and keep balance of yin and yang.