“肾不纳气”病机与“补肾纳气”治则探源

Source Exploration of"Kidney Deficiency Induced Qi Inspiration Dysfunction"Pathogenesis and Treatment of"Tonifying Kidney to Strengthen Qi Inspiration"

“肾不纳气”病机和“补肾纳气”治则的形成年代相对较晚,南宋时期,医家杨士瀛首先提出肾主纳气理论。《黄帝内经》是“肾不纳气”病机最原始、最主要的思想根源,后世诸多医家关于肺肾相关的阐述几乎是在此基础上所发。其中,足少阴肾经之直脉贯肺是产生“肾不纳气”的主要生理前提。肾元亏损、水邪犯肺、气机上逆、肾脏邪实所呈现出肺肾相关的疾病状态是“肾不纳气”病机的主要认识来源。杨士瀛师法于钱乙,钱乙著名的“肾无实证”理论对其学术思想造成一定的影响,加之肾中元气的特殊地位在诊疗实践中日渐凸显,这都促使肾元亏损所致摄纳无权的病机在杨氏理论体系中占据主体地位,由此衍化形成了后世的“肾不纳气”病机。病机是对疾病的诊断,治则是对疾病的疗法,二者的形成和发展历来相辅相成,由此,“补肾纳气”治则随之而成。

The pathogenesis of"Kidney deficiency induced Qi inspiration dysfunction"and the treatment of"tonifying Kidney to strengthen Qi inspiration"were proposed relatively late in TCM history.In the Southern Song Dynasty,the physician Yang Shiying first put forward the theory of Kidney governing Qi inspiration.Huang Di Nei Jing is the most primitive and main ideological root of this pathogenesis theory,based on which many illustrations made by the doctors in later generations of the Lung and Kidney correlation.Among them,the meridian of Kidney meridian of Foot Shaoyin go straightly to the Lung is the main physiological premise for it.The main sources of understanding this pathogenesis are the unhealthy conditions in Lung and Kidney relationship,such as the loss of Kidney Yuan Qi deficiency,Water evil factor injuring the Lung,upward reversal of Qi activity,and Kidney evil factor excess.Yang Shiying studied this issue by following Qian Yi′s thoughts,whose famous theory of"no excess case in Kidney syndromes"had a certain impact on Yang Shiying′s academic thoughts.In addition,the special status of the Kidney Yuan Qi became increasingly prominent in practice of diagnosis and treatment,which causes the pathogenesis of Kidney Yuan Qi deficiency induced Qi aspiration dysfunction of it occupy the main position in Yang′s theoretical system,which evolved into the pathogenesis of"Kidney deficiency induced Qi inspiration dysfunction in later generations.Pathogenesis belongs to the diagnosis of disease,and treatment principle belongs to the treatment of disease,and the formation and development of the two have always been complemented and supported to each other.