摘要
上热的主要病机为肺胃热盛、心肝火旺;下寒的病机主要是脾气虚弱、肾阳衰微。治疗原则为清上温下、疏化三焦,常用方剂有白虎汤、肾气丸、柴胡桂枝汤、交泰丸、引火汤、半夏泻心汤、黄连汤等,外治法有针刺、温灸等。上热下寒证是一类虚实相兼、病机复杂的临床证候,治疗上并非清热、温阳药物的简单叠加,而是需要深入分析病机后,再予恰当方药。关于临床诊治疗效,目前文献报道多是独立病案,以经验用药为主,疗效评价标准不统一,缺乏严谨性。今后应加强科研设计,多开展大样本、多中心的随机对照研究,执行统一、规范的试验步骤,以提高研究结果的真实性、客观性、可重复性。
The main pathogenesis of upper heat is excessive heat of lung and stomach,fire of heart and liver,while that of lower cold is insufficient spleen qi and kidney yang.The principle of treatment is clearing the upper and warming the lower,and dispersing triple energizer.The commonly used formulas include White Tiger Decoction,Kidney Qi Pill,Bupleurum and Cinnamon Twig Decoction,Pill for Restoring Coordination Between Heart and Kidney,Fire-Returning Decoction,Pinellia Heart-Draining Decoction,Coptis Decoction,etc.The external therapies include acupuncture,warming moxibustion,etc.The syndrome of upper heat and lower cold is a kind of clinical syndrome with intermingled deficiency and excess and complicated pathogenesis.The treatment is not a simple superposition of medicines for clearing away heat and warming yang.So it is necessary to analyze the pathogenesis and give appropriate formulas and medicines.At present,most of the reports on clinical diagnosis and treatment are independent medical records,mainly based on empirical medication,and the evaluation criteria are not unified and lack of rigor.In order to improve the authenticity,objectivity and repeatability of the research results,we should strengthen the design of scientific research,carry out more large sample and multi-center randomized controlled studies,and implement unified and standardized experimental procedures in the future.
作者
丁怀莹
王保和
DING Huai-ying;WANG Bao-he(Binhai New Area Hospital of Traditional Chinese Medicine of Tianjin,Tianjin,China,300451;The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China,300150)
出处
《河南中医》
2021年第1期16-19,共4页
Henan Traditional Chinese Medicine
基金
国家“重大新药创制”科技重大专项“十二五”第二批项目子课题项目(2012ZX09303-010-001)。
关键词
上热下寒证
“引火归元”
桂附八味丸
syndrome of upper heat and lower cold
"returning fire to its origin"
Cinnamon Twig and Poria Six-Ingredient Pill
