浙江中医药大学学报2025，Vol.49Issue(1)：59-64,6.DOI:10.16466/j.issn1005-5509.2025.01.010
基于张景岳"相火有形有位"理论探讨内伤热病的辨治
Treatment Based on Syndrome Differentiation in Internal Injury Fever Based on ZHANG Jingyue's Theory of"Ministerial Fire Has Tangible Position"
摘要
Abstract
[Objective]Based on ZHANG Jingyue's theory of"ministerial fire has a place and is visible",to explore the syndrome differentiation thinking and treatment plan about injury fever syndrome differentiation,in order to provide new ideas for the clinical treatment of internal injury fever such as deficiency fever,spermatorrhea,blood syndrome,diabetes syndrome and so on.[Methods]By studying the relevant works of ZHANG Jingyue's Jingyue Encyclopedia and Classified Classic,combined with the works of other doctors such as LIU Wansu,ZHU Danxi,LI Dongyuan,etc.,it discussed the application of ministerial fire thought in the syndrome differentiation and treatment of internal injury fever.Combined with medical records,three ideas of syndrome differentiation and treatment of internal injury fever were summarized:spleen-Qi deficiency,Yin essence deficiency and original Yang deficiency,corresponding to three treatment methods of regulating middle-Jiao,benefiting essence and blood,and warming body origin.Combined with clinical practice,it summarized the diagnostic and treatment thought of internal injury fever,and discussed the role of ZHANG Jingyue's ministerial fire theory in the treatment of specific febrile diseases such as deficiency fever,spermatorrhea,blood syndrome and diabetes syndrome.[Results]ZHANG Jingyue believed that ministerial fire"has a place",which was born in Mingmen and all over the viscera.All endogenous fevers in the human body were related to it.And ZHANG proposed that the incidence of internal injury fever was mainly deficiency,and ministerial fire was"tangible",which could be differentiated and treated according to the fact that ministerial fire must be damaged by"blood Qi,viscera and other evidence".Its pathogenesis mainly included three aspects:spleen-Qi deficiency,Yin essence deficiency and original Yang deficiency.The diagnosis and treatment should pay attention to regulating the middle palace and heat,benefiting essence and blood to make fire,warming kidney and life to absorb fire.According to the syndrome differentiation situation,in terms of medication,it should pay attention to the use of sweet and warm,sweet and cold drugs also warming and tonifying Yang prescriptions flexibly.[Conclusion]ZHANG Jingyue had a very profound understanding of the theory of ministerial fire.On the basis of absorbing the essence of predecessor's thoughts,he often had his own new insights.His theory of ministerial fire had important value in discussing the pathogenesis and treatment of internal injury fever,which was worthy of reference for the later generations.关键词
张景岳/内伤热病/相火/元气/肾阳/火非土不荣/虚损发热/命门Key words
ZHANG Jingyue/internal injury fever/ministerial fire/original Qi/kidney-Yang/fire does not flourish without soil/deficiency fever/Mingmen分类
医药卫生引用本文复制引用
秦雨筱,李想,谷建军..基于张景岳"相火有形有位"理论探讨内伤热病的辨治[J].浙江中医药大学学报,2025,49(1):59-64,6.基金项目
国家社科基金项目冷门绝学研究专项(22VJXG041) （22VJXG041）
北京市社科基金项目(20ZXB002) （20ZXB002）
北京中医药大学揭榜挂帅项目(2023-JYB-JBZD-067)National Social Science Foundation of China(22VJXG041) （2023-JYB-JBZD-067）
Beijing Social Science Fund Project(20ZXB002) （20ZXB002）
Beijing University of Chinese Medicine Unveiled Project(2023-JYB-JBZD-067) （2023-JYB-JBZD-067）
