裴林治疗上热下寒证经验

Pei Lin′s Experience of Treating the Syndrome of Upper Heat and Lower Cold

裴林教授认为,内伤杂病的发生发展与三焦密不可分,三焦运行人体产生的诸气,传输布散运化产生的水谷精微,气血以此为通路,气机阻滞、气血运行不调会导致内伤杂病的发生,病情缠绵难愈,大多虚实寒热并见,临床可结合三焦辨证治疗,三焦辨证不仅包括脏腑辨证,也包括卫气营血辨证。裴教授认为,上热下寒证的病机是人体气机不畅,中焦阻滞不通,阴阳不能交通上下,会出现“上热下寒”,治疗应从调和阴阳入手,以通利三焦、调畅气机为要,清上焦热,温下焦寒,引下焦虚火归元,并将上热下寒证分为:上焦热,下焦寒;上焦热,中焦寒;中焦热,下焦寒。裴教授常用黄连、黄芩清上焦之热,以附子、巴戟天温下焦之寒,肉桂引下焦上浮之阳回归。

Professor Pei Lin believes that the occurrence and development of internal injuries and miscellaneous diseases are closely re⁃lated to the triple energizer,which moves all kinds of qi in the human body,transports and distributes food essence,acts as the access of qi and blood.Qi movement blockage and qi⁃blood dysfunction lead to the occurrence of internal injuries and miscellaneous diseases,which are lingering and difficult to cure.Most of them are mixed deficiency and excess with cold and heat.Clinical treatment can be combined with syndrome differentiation of the triple energizer,which includes not only the syndrome differentiation of viscera,but also the syndrome differentiation of defense qi and nutrient⁃blood.Professor Pei believes that the pathogenesis of the syndrome of upper heat and lower cold is that the human qi movement is not smooth,the middle energizer is blocked,yin and yang can not connect,which will lead to"upper heat and lower cold".The treatment should start from the reconciliation of yin and yang,with dredging the triple energi⁃zer,regulating qi movement as the main point,so as to clear the upper energizer heat,warm the lower energizer cold,and conducting the lower energizer deficient fire back to the original.Syndrome of upper heat and lower cold can be divided into:the hot upper energizer and the cold lower energizer;the hot upper energizer and the cold middle energizer;the hot middle energizer and the cold lower energi⁃zer.Professor Pei often uses Huanglian(Rhizoma Coptidis)and Huangqin(Radix Scutellariae)to clear the heat of the upper energizer;Fuzi(Radix Aconiti Lateralis Preparata)and Bajitian(Radix Morindae Officinalis)to warm the cold of the lower energizer;and Rougui(Cortex Cinnamomi)to conducting the floating yang in the lower energizer to its origin.