摘要
火郁证,既有火的表现,又有郁的病机,为火热被外感六淫、内伤七情或气血湿痰郁遏所致。风寒邪气袭表入里,闭郁气机,也可引发一系列火郁证候。以病位言之,火郁证有表里上下之别;以病理因素言之,有气血湿痰之异;以脏腑言之,又有心肝脾肺肾的不同。《伤寒论》中,火郁在表者,麻黄汤或桂枝二越婢一汤主之;化热入里者,大青龙汤主之;郁热在上者,半夏散及汤主之;郁热在下者,用大承气汤;血分郁热者,用桃核承气汤;湿阻郁热者,茵陈蒿汤主之;痰阻郁热者,小陷胸汤主之;因虚致火郁者,小建中汤主之;心经火郁者,栀子豉汤主之;肺经火郁者,用麻黄杏仁甘草石膏汤;脾胃火郁者,大黄黄连泻心汤主之;肝胆火郁,用乌梅丸或小柴胡汤;肾经火郁者,四逆散主之。在上在表者,开之发之;在里在下者,泻之导之。在用药方面,有解郁和除热两端,多寒温并用,选用温药开其郁结、展布气机;寒药解散郁热,药宜清轻,切忌过用苦寒,致冰伏气机。
The fire stagnation syndrome has both the manifestation of fire and the pathogenesis of stagnation.It is caused by the six erosions of external factors,the seven emotions of internal injury or the stagnation of qi,blood and phlegm.Wind-cold pathogenic qi attacking the exterior and invading the interior and closing the qi movement can also trigger a series of complex syndromes of fire stagnation.In terms of disease position,there are differences between the exterior and the interior.In terms of pathological factors,there are differences between qi,blood,dampness and phlegm.In terms of viscera,there are differences between heart,liver,spleen,lung and kidney.In Treatise on Cold Damage Diseases,for those with fire stagnation on the exterior,Ephedra Decoction or combination of two dosages of Cinnamon Twig Decoction and one dosage of Maidservant from Yue Decoction can be used.For those with transforming heat into the interior,Major Green Dragon Decoction can be used.For those with stagnant heat in the upper part of the body,Pinellia Power or Decoction can be used.For those with stagnant heat in the lower part of the body,Major Purgative Decoction can be used.For those with stagnant heat in blood aspect,Semen Juglandis Purgative Decoction can be used.For those with stagnant heat and dampness,Virgate Wormwood Decoction can be used.For those with stagnant heat and phlegm obstruction,Minor Chest-Draining Decoction can be used.For those with stagnant heat due to deficiency,Minor Center-Fortifying Decoction can be used.For those with stagnant heat in the heart meridian,Gardenia and Semen Sojae Praeparatum Decoction can be used.For those with stagnant heat in lung meridian,Ephedra and Apricot Kernel,Gypsum and Licorice Decoction can be used.For those with stagnant heat in the spleen and stomach,Rhubarb and Coptis Heart-Draining Decoction can be used.For those with stagnant heat in the liver and gallbladder,Mume Pill or Minor Bupleurum Decoction can be used.For those with stagnant heat in the kidney meridian,Frigid Extremities
作者
乔普荣
汤琪
李芳
徐俊
尹谢添
QIAO Pu-rong;TANG Qi;LI Fang;XU Jun;YIN Xie-tian(Gongan County Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine,Gongan,Hubei,China,434300;Hubei University of Chinese Medicine,Wuhan,Hubei,China,430065;Hubei Provincial Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine,Wuhan,Hubei,China,430060)
出处
《河南中医》
2022年第4期491-494,共4页
Henan Traditional Chinese Medicine
基金
湖北省卫生健康委员会中医药科研项目(ZY2021Q042)。
关键词
火郁证
火郁发之
《伤寒论》
张仲景
fire stagnation syndrome
fire stagnation occurrence
Treatise on Cold Damage Diseases
Zhang Zhong-jing
