李东垣辨治湿热病学术观点与特色*
作者：张婉萍，崔家祥，袁 茵，王洪海
单位：山东中医药大学中医学院，山东 济南 250355
引用：引用：张婉萍，崔家祥，袁茵，王洪海.李东垣辨治湿热病学术观点与特色[J].中医药导报,2025,31(8):220-223.
DOI：10.13862/j.cn43-1446/r.2025.08.037
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摘要：李东垣认为辨治湿热病的关键是脾胃元气的充盛与否。在病因病机上，李东垣认为脾胃虚弱是湿热病发生的关键因素，脾胃虚弱可使肺金受损诱发湿热，还会出现湿热邪气累及肝肾、四脏同时受损、湿热之邪累及大肠等证，此外暑邪干卫也是湿热病产生的重要原因。在治疗上，李东垣注重顾护脾胃之气，提出了以下治疗原则：健脾益肺，清热燥湿；运脾疏肝滋肾，清肝经之湿热；清肠泻湿，行气调血；清暑益卫，燥湿滋肾；等等。在用药方面，李东垣注重组方，重视脏腑、五行的生克制化；善用黄芪、党参、炙甘草等调护胃气，黄芩、黄连、黄柏等清热燥湿，同时还重视气候、地域对人体的影响，主张因时、因地用药，辨证处方，灵活加减，且注重药物的适当炮制，颇具临证价值。
关键词：湿热病；李东垣；脾胃；清热燥湿
Abstract：
LI Dongyuan believed that the key to
differentiating and treating damp-heat diseases lies in the sufficiency of
spleen-stomach primordial Qi. In terms of etiology and pathogenesis, LI
Dongyuan believed that spleen-stomach deficiency is a critical factor in the
occurrence of damp-heat diseases. Deficiency of spleen and stomach can damage
lung gold and induce damp-heat, and there will be syndromes such as damp-heat
pathogen involving liver and kidney, simultaneous damage of four organs,
damp-heat pathogen involving large intestine, etc. In addition, summer-heat
pathogen is also an important cause of damp-heat disease. In treatment, LI
Dongyuan paid attention to protecting the Qi of the spleen and stomach, and put
forward the following therapeutic principles: strengthening the spleen and
benefiting the lung, clearing heat and drying dampness; activating the spleen,
soothing the liver, and nourishing the kidney to clear damp-heat in the liver
meridian; clearing the intestine and draining dampness to promote Qi
circulation and regulate blood; clearing summer-heat and reinforcing defensive
Qi, drying dampness and nourishing the kidney, etc. In terms of medication, LI
Dongyuan focused on prescription formulation, emphasizing the
generation-restriction relationships among viscera and the five elements. He
was skilled in using herbs such as Huangqi (Scutellariae Radix), Dangshen
(Codonopsis Radix), and Zhigancao (Glycyrrhizae Radix cum Liquido Fricta) to
regulate and protect stomach Qi, and herbs like Huangqi (Scutellariae Radix),
Huanglian (Coptidis Rhizoma), and Huangbai (Phellodendri Cortex) to clear heat
and dry dampness. Meanwhile, he attached importance to the impact of climate
and region on the human body, advocating medication based on time and location,
prescribe according to syndrome differentiation, flexible addition and
subtraction of medicines, and emphasized appropriate processing of medicines,
which has significant clinical value.
Key words：damp-heat disease; LI Dongyuan; spleen and stomach; clearing heat and drying dampness
发布时间：2026-01-07
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