《脾胃论》绪余
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摘要
通过对《脾胃论》甘温升散有余、寒凉清解不足之成因的分析,认为李杲所处多"饥苦劳役"的历史时期是其"脾胃内伤,百病由生"等核心理念形成的重要因素。随着社会的改变,病因病机已发生显著变化,脾实日渐而"气涩血浊",故浊毒内蕴已成为当今脾胃病变之重要机制,如以辨病辨证相结合之思维方式认识和研究脾胃病变,可发现其内涵远较李杲时代"脾胃气虚"和"阴火"广泛。现代脾胃病是涉及多系统性疾病群,辨治理法亦当与时俱进,应甘温辛散与寒凉清解相济,探求李杲脾胃之旨,以演其学,助解"古方新病不相能"之困。
Through the analysis of the causes of the sufficient ascending and dispersive sweet and warm,and insufficient clearing and resolving cold and cool in Treatise on Spleen and Stomach(《脾胃论》),it is believed that the historical period of LI Dongyuan with many "starvation,hardship,and forced labor" is the important factor of the formation of core concept of "internal injury of spleen and stomach,all diseases occurred". With the change of society,the etiology and pathogenesis has undergone significant changes,and the spleen is gradually becoming excessive,and"qi astringent and blood turbid". Therefore,the internal retention of turbidity toxin has become an important mechanism of spleen and stomach lesions today. For example,the understanding and study on spleen and stomach lesions by way of thinking based on the combination of disease differentiation and syndrome differentiation has far more extensive connotation than the "spleen and stomach qi deficiency" and "yin fire" in the LI Dongyuan era. Modern spleen and stomach disease is a group of diseases involving multiple systems. The method of differentiation and treatment should also advance with the times. It should be treated with sweet,warm,pungent and dispersive combined with cold,cool,clear and resolving,to explore the purpose of LI Dongyuan's spleen and stomach theory and to learn his academic thoughts,so as to help solve the problem of "the ancient formula cannot treat modern diseases".
Through the analysis of the causes of the sufficient ascending and dispersive sweet and warm,and insufficient clearing and resolving cold and cool in Treatise on Spleen and Stomach(《脾胃论》),it is believed that the historical period of LI Dongyuan with many "starvation,hardship,and forced labor" is the important factor of the formation of core concept of "internal injury of spleen and stomach,all diseases occurred". With the change of society,the etiology and pathogenesis has undergone significant changes,and the spleen is gradually becoming excessive,and"qi astringent and blood turbid". Therefore,the internal retention of turbidity toxin has become an important mechanism of spleen and stomach lesions today. For example,the understanding and study on spleen and stomach lesions by way of thinking based on the combination of disease differentiation and syndrome differentiation has far more extensive connotation than the "spleen and stomach qi deficiency" and "yin fire" in the LI Dongyuan era. Modern spleen and stomach disease is a group of diseases involving multiple systems. The method of differentiation and treatment should also advance with the times. It should be treated with sweet,warm,pungent and dispersive combined with cold,cool,clear and resolving,to explore the purpose of LI Dongyuan's spleen and stomach theory and to learn his academic thoughts,so as to help solve the problem of "the ancient formula cannot treat modern diseases".
引文
[1]吴深涛.论浊与湿异[J].中华中医药杂志,2011,26(9):1931-1933.
[2]PAL S,BLAIS JM,ROBIDOUX MA,et al.The association of type 2 diabetes and insulin resistance/secretion with persistent organic pollutants in two First Nations communities in northern Ontario[J].Diabetes Metab,2013,39(6):497-504.
[3]吴深涛,章清华,刘弘毅,等.内毒蓄损与“生生之气”失衡:现代病证的核心机制[J].中医杂志,2016,57(23):1985-1988.
[4]李付平,康立英,杨贵真,等.基于数据挖掘分析《脾胃论》用药组方规律[J].广州中医药大学学报,2019,36(2):288-291.
[2]PAL S,BLAIS JM,ROBIDOUX MA,et al.The association of type 2 diabetes and insulin resistance/secretion with persistent organic pollutants in two First Nations communities in northern Ontario[J].Diabetes Metab,2013,39(6):497-504.
[3]吴深涛,章清华,刘弘毅,等.内毒蓄损与“生生之气”失衡:现代病证的核心机制[J].中医杂志,2016,57(23):1985-1988.
[4]李付平,康立英,杨贵真,等.基于数据挖掘分析《脾胃论》用药组方规律[J].广州中医药大学学报,2019,36(2):288-291.