摘要
五脏之火,以心肝最炽,其次是肺脾,久则及肾。心居丙丁火位,为火热之脏,五志过极皆能化火,且必将偏旺于心,手少阴心经挟咽循行,故治疗慢性咽炎,可以少阴为枢,以桔梗汤为基础方加味,清宣少阴心之伏火;少阳枢机不利,情志不畅,郁而化火,肝胆火旺是慢性咽炎的常见病机之一,故临床上常以小柴胡汤和黄芩汤为基础方加减治疗慢性咽炎;肺火喉痹,常以虚火为主,方用贝母瓜蒌散合养阴清肺汤加减,以润肺养阴,清热化痰。若偏于实火者,则以泻白散加减,以泻肺中之伏火,另木火刑金,此类咽喉不利以张景岳化肝煎为基础合清肺利咽之品治疗;若脾有伏火,伏火循经上扰,灼伤咽津,而出现咽干咽痛,口唇干燥、糜烂,烦渴易饥等临床表现,方用泻黄散合竹叶石膏汤加减,以泻脾经之伏火,若久病,脾胃气阳两虚,可与小建中汤、补中益气汤等;久病及肾,或素体肺肾阴虚,水之下源无以汲养,虚火上炎,发为喉痹,方用左归丸合知柏地黄丸加减,以壮水之主,滋阴降火。若疾病日久,阴损及阳,则在半夏散(汤)的基础上加温肾药物,若阴阳两虚,则可酌情加入滋阴补肾之品。辨清"火"所在脏腑及相兼之脏,分清主次,辨证施治,方能不失偏颇,取得较好疗效。
Among fire of five viscera,heart fire and liver fire are the fiercest.The heart occupies the position of fire,and is the fire zang organ.Overacting of five minds will transform into fire,and the heart fire will surely be excessive.The Heart Meridian of Hand-Shaoyin moves up along the throat,so in the treatment of chronic pharyngitis,Shaoyin is the pivot,and Radix Platycodonis decoction can be used as the basis to modify for clearing away the latent heart fire.If Shaoyang pivot is unfavorable,emotional disorder,and depression transforming into fire will appear.Excessive liver and gallbladder fire is one of the common pathogenesis of chronic pharyngitis,so Minor Bupleurum Decoction and Scutellaria Decoction can be used as the basis to modify for treating chronic pharyngitis.Throat arthralgia due to lung fire is often based on deficient fire,so Modified Bulbus Fritillariae and Trichosanthes Powder combined with Yin-Nourishing and Lung-Clearing Decoction is used for moistening lung and nourishing yin,clearing heat and resolving phlegm.For excessive fire,Modified White-Draining Powder is often used for purging latent fire in the lung.For hepatopyretic impairment of lung,Zhang Jing-yue′s Liver-Resolving Decoction is often combined with medicinals for clearing lung and easing the throat for treating it.For latent fire in the spleen moving along meridian upward burning throat fluid causing dry and sore throat,dry mouth and lips,erosion,thirst and hunger,etc.,Modified Yellow-Draining Powder combined with Lophatherum and Gypsum Decoction is often used for purging latent fire in the Spleen Meridian.For chronic disease with both spleen-stomach qi and yang,Center-Supplementing and Qi-Boosting Decoction,and Minor Center-Fortifying Decoction are often used.For long-term illness involving the kidney,or body lung and kidney yin deficiency,water source cannot be nourished,flaring-up of fire of deficiency type will lead to throat arthralgia,then Left-Restoring Pill combined with Modified Anemarrhena and Phellodendron and Rehmanni
作者
赵烨
杨志华
闫海峰
宋俊生
ZHAO Ye;YANG Zhi-hua;YAN Hai-feng;SONG Jun-sheng(Tianjin University of TCM,Tianjin,China,301617;First Affiliated Hospital of Tianjin University of TCM,Tianjin,China,300381)
出处
《河南中医》
2019年第10期1467-1470,共4页
Henan Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81373891)
关键词
慢性咽炎
五脏之火
心火
肝(胆)火
肺火
脾(胃)火
肾火
chronic pharyngitis
fire of five viscera
heart fire
liver(gallbladder)fire
lung fire
spleen(stomach)fire
kidney fire
