河南中医2025，Vol.45Issue(10)：1459-1463,5.DOI:10.16367/j.issn.1003-5028.2025.10.0236
从中焦枢机不利探析甘草泻心汤治疗上热下寒证
Exploring the Treatment of Upper-Heat and Lower-Cold Syndrome with Licorice Heart-Draining Decoction from the Perspective of Dysfunction of the Middle Energizer Pivot
摘要
Abstract
The core pathogenesis of upper-heat and lower-cold syndrome lies in the imbalance of yin and yang and the reversed flow of qi movement,with dysfunction of the middle energizer pivot being a key pathological link.The mechanism involves three critical as-pects:First,blockage in the middle energizer,leading to dysfunction of spleen-stomach in ascending and descending.Second,deficiency yang floating upward due to genuine yang insufficiency and excessive cold in the lower energizer,forcing deficient fire to rise.Third,im-paired qi transformation in the triple energizer,damaging the middle energizer's fermenting function,resulting in clear qi failing to as-cend causing diarrhea with undigested food and turbid qi failing to descend causing chest irritation and heat.Licorice Heart-Draining Decoction focuses on restoring the ascending-descending pivot of the middle energizer.In the formula,four liang of Zhiancao(Radix Glycyrrhizae Praeparata)serves as the sovereign ingredient,being sweet and neutral to fortify the center,combined with twelve pieces of sweet and moist Dazao(Fructus Jujubae)to nourish the nutrient yin of the middle energizer,forming the foundation of"sweetness to moderate and tonify deficiency."Three liang of Ganjiang(Rhizoma Zingiberis)and half a sheng of Banxia(Rhizoma Pinelliae),being pungent and warm,are added to unblock yang and resolve cold congelation in the middle energizer.Three liang of Huangqin(Radix Scutellariae)and one liang of Huanglian(Rhizoma Coptidis),being bitter and cold,descend and clear depressed heat floating upward.The whole formula simultaneously tonifies and purges,addressing deficiency of the middle energizer,resolving cold-heat entanglement,and regulating reversed qi movement.Ultimately,it restores"spleen ascending and stomach descending,like a wheel turning around an axis."Once the function of the middle energizer pivot is recovered,the conflict between upper heat and lower cold is naturally resolved.关键词
上热下寒证/甘草泻心汤/中焦枢机不利/三焦/四维/方基/《伤寒论》/《金匮要略》/张仲景Key words
upper-heat and lower-cold syndrome/Licorice Heart-Draining Decoction/dysfunction of the middle energizer pivot/triple en-ergizer/four dimensions/formula foundation pair/Treatise on Cold Damage Diseases/Synopsis of the Golden Chamber/Zhang Zhongjing分类
医药卫生引用本文复制引用
王得力,刘纳文,黄山..从中焦枢机不利探析甘草泻心汤治疗上热下寒证[J].河南中医,2025,45(10):1459-1463,5.基金项目
2024年度天津市名中医传承工作室建设项目{津卫中[2024]61号} （）
