中医临床研究2025，Vol.17Issue(22)：92-97,6.DOI:10.3969/j.issn.1674-7860.2025.22.011
金元医学流派视角下李东垣与朱丹溪痔漏诊疗思想对比及现代启示
A comparative study on LI Dongyuan and ZHU Danxi's diagnostic and therapeutic approaches for hemorrhoids from the perspective of Jin-Yuan medical schools and its modern implications
摘要
Abstract
Objective:To systematically compare the similarities and differences in the academic thoughts of LI Gao and ZHU Zhenheng,two prominent TCM masters in the Jin and Yuan Dynasties,in the diagnosis and treatment of hemorrhoids,conduct an in-depth analysis of the theoretical origins and formative backgrounds of their concepts,and probe into their guiding significance for the diagnosis and treatment of anorectal diseases in modern traditional Chinese medicine.Methods:Utilizing the research methodologies of philology and historical comparison,a systematic collation was carried out with classic works such as Lanshi Micang(《兰室秘藏》)and Danxi Xinfa(《丹溪心法》)as core texts.Special emphasis was placed on contrasting the differences between the two works in aspects of disease name classification,etiology and pathogenesis,therapeutic principles and strategies,prescription selection and medication,and external treatment techniques of hemorrhoids.Moreover,their academic characteristics were expounded in the context of the historical backdrop of the Jin and Yuan dynasties.Results:Although both of them grounded in the theoretical foundation of"deficiency caused by internal injuries",there were marked disparities in their theoretical frameworks and clinical practices.LI Gao established the"Yin(阴)fire theory",emphasizing that internal injuries to the spleen and stomach leads to Qi transformation imbalance,with clear Yang(阳)failing to ascend and turbid Yin descending.The treatment was based on the principle of"elevating Yang and purging fire",and representative prescriptions such as Qinjiao Baizhu Wan(秦艽白术丸)highlight the synergistic compatibility of wind medicinals for Yang elevation and bitter-cold medicinals for fire reduction.ZHU Danxi put forward the"ministerial fire theory",believed that emotional disorders and excessive sexual indulgence leaded to blood heat and stasis,and systematically established a staged diagnosis and treatment paradigm for hemorrhoids,which was divided into the hemorroide unruptured stage and the hemorroide ruptured stage.In terms of the treatment,the emphasis was placed on"cooling blood and purging fire",and Huaijiao(Fructus sophorae)and Diyu(Radix Sanguisorbae)was used to cool blood and detoxify during the hemorrhoid unruptured stage,and Renshen(Radix Ginseng)and Huangqi(Radix Astragali)were used in large doses to tonify deficiency and promote tissue regeneration during the hemorrhoid ruptured stage.Moreover,ZHU Danxi also systematically advanced external treatment techniques such as fumigation and plaster application.Conclusion:The holistic regulation and treatment concept of LI Gao and the precise syndrome differentiation-based treatment model of ZHU Danxi complement each other.The former is well suited for the conditioning of chronic deficiency syndromes,whereas the latter is particularly adept at intervening in acute excess syndromes.The combination of the two approaches offers theoretical underpinnings for the contemporary"integration of disease and syndrome"diagnostic and therapeutic paradigm.Moreover,the integration of their external treatment methods with modern techniques represents an important approach to innovation.关键词
痔漏/相火论/阴火学说/外治法Key words
Hemorrhoids/Ministerial fire theory/Yin fire theory/External treatment分类
医药卫生引用本文复制引用
胡正强,潘雨溪,徐楚楚,白钜澄,方征宇..金元医学流派视角下李东垣与朱丹溪痔漏诊疗思想对比及现代启示[J].中医临床研究,2025,17(22):92-97,6.基金项目
浙江省中医药科技计划项目(2021ZA053、2020ZA054). （2021ZA053、2020ZA054）
