目的：李东垣所提出的“阴火”理论经过数千年的流传, 历代说法百家齐放，故直至今曰“阴火”理论也尚未得到一个统一的答案。医易同源，中医的文化根底来源于《周易》中，从《内经》、《伤寒杂病论》中都先生处体现着《周易》的思想, 所以本研究目的是运用《周易》中的思想与方法结合李东垣的著作原文来对李东垣“阴火”思想的进行对应论证，再次对“阴火”理论的名称含义、病因、病机等进行研究认识，以期为阴火理论的求真过程增添一分参考与开拓一个新的思路。方法：在系统详细学习李东垣的著作后, 运用文献学研究方法，通过对李东垣的著作原文进行剖析；以及通过数据库文献搜索方式收集现今各医家学者对李东垣“阴火”理论的论证，提炼当中理论，进行归纳与总结，再结合运用《周易》中的思想与方法进行论泣, 从而系统地阐释“阴火”理论并着重解释阴火病机。本研究得出：1 .医易同源最早始可见于《内经》以及《伤寒论》。而阴火的理论同样源于《内经》与《伤寒论》, 因此能用《周易》思维与方法来解释阴火机理。2. 阴火的理论来源于《黄帝内经》的“阴虚生内热”，此阴虚指内伤之意，与外戚为阳相对而言。治法的启示起源于张仲景小建中汤的“甘温除热”法并加以发展而成益气升阳法。3. 李东垣治疗阴火所使用的益气升阳法，即土伏火法。从《周易》中后天八卦可推出良、坤二土伏坎、离二火，对应中医生理中即脾胃中土伏君相二火。因此治疗阴火即是恢复脾胃中土伏住君相二火, 故土伏火法治疗的阴火是作乱的君相二火。4. 李东垣的脾胃升降理论源于《周易》的阴阳彼此消长转化。“阳升极而化阴下”为升降理论失键；脾胃水谷精气, 上滋于六腑之(阳)气, 六腑传导水谷之物, 六腑阳气鼓动水谷精气上升至肺部，谷气与自然清气在肺合成后天之宗气，其中水谷清气中清中之清者化作宗气后充养五脏六腑之元气；清中之浊者化作宗气后别出于脉外成卫气卫表温分肉, 这些就是“阳升至极”；而“千七阴而下”则是谷气中浊中之清者于升至肺后液化成营气与津液，降至中院相合于心炼赤化血；浊中之浊者固化精下藏肾强骨充髓；气血津液生成有源, 运行畅顺，脏腑功能正常，这就是李东垣的脾胃升降理论。5. 李东垣的阴火是以脾胃气虚为病理基础的内伤之火。初因情志内伤、饮食不节、劳役过度会引发脾胃气虚，升降失常, 元气不足, 进而心气阴不足，及湿浊下流肾间郁而化热，相火妄动，心君化火，出现君相二火作乱的病理状态。君相二火复乘脾胃, 引发更严重的脾胃升降失常, 元气愈虚，从而出现全身各脏腑虚损，呈现阴虚、血虚、气郁、湿浊、湿热等病机因素, 故现五脏六腑经脉火邪，此亦为阴火。關键词：阴火阴火理论阴火病机升降理论周易李东垣
Objection: the theory of ''Yin-Huo" had been come up with Li Dongyuan have not been gotten the consensus in nowadays. The root of I Ching theory and traditional Chinese medicine is the same. The think model and the method of I Ching theory are present to "Huang Di Nei Jing” and “Treatise on Febrile Diseases”. Therefore, the purpose of this study is to demonstrate the thought of Li Dongyuan's “Yin-Huo” theory with using the thinking and methods by I Ching theory combined with the clauses in the books belongs to Li Dongyuan. In order to add a reference and develop a new way of thinking for the theory of “Yin-Huo", we restudy about the connotation of name, the cause of disease and the pathogenesis of “Yin-Huo" theory.
Methods: after systematic study of Li Dongyuan's articles, using the literature research method, through the analysis of Li Dongyuan's original articles and the search way to collect the scholars of Li Dongyuan's "Yin-Huo" theory through the literature database, which refines the theory, and summarized, combined with the use of thinking and methods in I Ching theory are discussed, thus to explain the system of “Yin-Huo” theory and explain the pathogenesis of it.
Conclusion: 1. I Ching theory and traditional Chinese medicine to be the same as the original can be seen in the "Neijing" and "Treatise on Febrile Diseases". The theory of "Yin-Huo" is also derived from "Neijing" and "Treatise on Febrile Diseases", so it can be used to explain the principle of "Yin-Huo". 2. the theory of “Yin-Huo" theory comes from the clause that "Yin deficiency endogenous heat" from the "Huang Di Nei Jing”, which refers to the meaning of internal injury which relatively constract with disease which infected from external. Treatment method comes from Zhang Zhongjing “Xiao Jianzhong soup” which has the mean of sweet and warm tastes removing fever. Eventually , the treatment method develop into the mthod of "therapy of benefiting qi and elevating yang". 3. The treatment method of “Yin-Huo" is "therapy of benefiting qi and elevating yang” by Li Dongyuan, which is equal to the method of soil control fire. The hexagram Gen and hexagram Kun mean soil controls the fire mean by hexagram Kan and hexagram Li, which like the spleen and stomach control the heart-fire and ministerial fire in the basic theories of Chinese medicine. 4. The upbearing and downbearing theory of spleen and stomach by Li Dongyuan root in the transformation between with Yin and Yang. Yang rises to pole into Yin is the key to the upbearing and downbearing theory. Firstly, The cereal essence and air transport to the six hollow organs. Secondly, the six hollow organs transfer the essence derived from food into the lung which the essence derived from food and air synthesize pectoral qi. The pectoral qi divides into four elements which is the Yang within Yang , Yang within Yin, Yin within Yang, Yin within Yin. The Yang within Yang develops the Promordial Qi of Internal organs. The Yin within Yang is to transform into defensive qi to protect fleshy exterior. The Yang within Yin transform into ying-qi and body fluid to creat blood. The Yin within Yin transform into essence which was saved in kidney to keep the stone srong and fuiling with brains. The qi-blood-body fluid is regular and Yang transform into Yin, which is the consequence of the upbearing and downbearing theory of spleen and stomach by Li Dongyuan. 5. the theory of "Yin-Huo" is internal injuries which is based on the pathological basis of spleen stomach qi deficiency. Because of the internal injuries caused by seven emotions, improper diet and overworked, the spleen stomach qi deficiency will take place. The spleen stomach qi deficiency make upbearing and downbearing of spleen and stomach is abnormal, which lead to lack Promordial Qi and then Qi Yin deficiency of heart, that occur the heartfire. Meanwhile, Because under the damp evil resistance in the kidney, so cause the ministerial fire. Heart-fire and ministerial fire attack spleen and stomach together, which lead to worse abnormal upbearing and downbearing of spleen and stomach. The worse upbearing and downbearing is, the worse Promordial Qi contribute to weakness of the viscera. Thus, there are some pathogenesis which are deficiency of yin, deficiency of blood, qi depression and dampness-heat lead to the occurrence of “ Yin-Huo”. Key words: Yin-Huo, Yin-Huo theory, Yin-Huo pathogenesis, upbearing and downbearing theory, I Ching theory, Li Dongyuan
|Date of Award
|10 Jun 2017
|Xuebin ZHANG (Supervisor)
- 李杲, 1180-1251.