摘要
"移热"理论来源于《素问·气厥论篇》,是消渴病形成及发展演变的重要病机.本文通过整理古今医家有关"移热"论述,探讨"移热"在消渴病病机演变规律中的作用."移热"病位多涉及心、肺、脾、胃、大肠、肾、膀胱.传变时可由心火亢盛,心阴不足,移热于肺,形成上消.脾和大肠受饮食积热化生火邪,传于胃而成中消,病性以燥热实火为主.上消、中消久病传热于肾及膀胱为下消,阴虚为主要病性.阴虚日久不愈,复灼上、中焦,加重全身症状.随着热邪转移,出现燥热、郁热、瘀热、虚热等病性变化.据此规律,治上焦当以清肺泻火、养阴滋阴.治中焦则并用清脾热养脾阴、泻肠腑热,防热下传.当下焦阴亏,宜滋补肾阴,防邪复传.本研究可为现代 2 型糖尿病病机演变及辨证论治提供理论基础.
Abstract
The theory of"heat transfer"comes from Su Wen·Qi Jue Lun,which is an important pathogenesis of the formation,development and evolution of Xiaoke disease.This article discusses the role of"heat transfer"in the pathogenesis and evolution of Xiaoke disease by arranging the discourses about"heat transfer"by ancient physicians."Heat transfer"mostly involves the heart,lung,spleen,stomach,large intestine,kidney,and bladder.When it is transmitted,it can be caused by excessive heart fire and insufficient heart Yin,which can transfer heat to the lungs and form upward elimination.The spleen and large intestine are transformed by the accumulation of heat from the diet to generate fire pathogens,which are transmitted to the stomach and become neutralized.The upper elimination and the middle elimination are chronic diseases with heat transfer and kidney and bladder for the lower elimination,and Yin deficiency is the main disease.Yin deficiency will not heal for a long time,and the upper and middle burners will burn again,aggravating systemic symptoms.With the transfer of heat pathogens,pathological changes such as dry heat,stagnant heat,stasis heat,and deficient heat appear.According to this rule,the treatment of upper-Jiao should be to clear the lungs,purify fire and nourish Yin.In the treatment of middle-Jiao,clearing spleen-heat and nourishing spleen-Yin,purging bowel and Fu-organ heat,preventing heat from spreading down.At present,when lower-Jiao Yin is deficient,it is advisable to nourish kidney-Yin and prevent the recurrence of pathogens.It provides a theoretical basis for the pathogenesis evolution and syndrome differentiation and treatment of type 2 diabetes.
基金项目
国家重点研发计划"中医药现代化研究"重点专项(2018YFC1704400)
国家中医药领军人才岐黄学者支持项目(国中医药人教函[2022]6号)
国家科技期刊平台
NSTL
万方数据