刘完素与李东垣运用风药治疗郁火之特点*

作者：赵梦涵，许璐司，李肇阳，袁 媛，黄湘媛，刘午阳，高利东，袁卫玲

单位：天津中医药大学中医学院，天津 301617

引用：引用：赵梦涵，许璐司，李肇阳，袁媛，黄湘媛，刘午阳，高利东，袁卫玲.刘完素与李东垣运用风药治疗郁火之特点[J].中医药导报,2025,31(10):221-225.

DOI：10.13862/j.cn43-1446/r.2025.10.041

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摘要：

剖析刘完素与李东垣对于郁火病因病机的认知，以及运用风药治疗郁火的特点，旨在更深入地领会运用风药配伍以发散郁火的思想。在《黄帝内经》“火郁发之”理论指导下，刘完素以“火热论”为核心，从“玄府闭塞”角度认识郁火，认为玄府是气机升降出入的重要道路门户，闭塞易导致气机郁滞化火，治疗上多用治风之药开发玄府郁结，配伍苦寒之品以清热开郁；其用药特点为治风之药用量相对寒凉之品较少，以避免助热伤正，代表方为防风通圣散。李东垣则以“脾胃学说”为基础，认为脾胃气虚、阳气不升是郁火的重要病机，治疗上他创新性地提出法象风药与甘温之品配伍以治气虚不运之郁火；其用药特点为法象风药用量因治疗目的和患者正气强弱不同而有所差异，但总体上注重轻灵用量，以顾护脾胃，代表方为升阳散火汤。

关键词：郁火；风药；刘完素；李东垣；火郁发之；脾胃学说

Abstract：

This paper analyzes LIU Wansu's and LI Dongyuan's understandings of the etiology and pathogenesis of stagnated fire, as well as their characteristics in using wind-resolving herbs to treat stagnated fire, aiming to gain a deeper understanding of the thought of using wind herbs in compatibility to disperse stagnated fire. Under the guidance of the theory of "Huo Yu Fa Zhi" in Huang Di Nei Jing, LIU Wansu, with his "fire and heat theory" as the core, understood depressed fire from the perspective of "Xuanfu obstruction". He proposed that Xuanfu is the pathway and gateway for the ascending, descending, entering, and exiting of Qi. Obstruction of Xuanfu leads to Qi stagnation, which then transforms into fire. In treatment, he often used wind-dispelling herbs to release the obstruction of Xuanfu and combined them with bitter and cold herbs to clear heat and disperse stagnant fire. The characteristic of his medication is that the amount of wind-dispelling herbs is relatively less than that of cold-cooling herbs to avoid assisting heat and harming the Qi. The representative formula is Fangfeng Tongsheng San (防风通圣散). Li Dongyuan, on the other hand, based on the "spleen and stomach theory", believed that deficiency of spleen and stomach Qi and failure of Yang to ascend are important pathomechanisms of stagnant fire. In treatment, he innovatively proposed to combine symbolic wind herbs with sweet and warm herbs to treat the stagnant fire caused by Qi deficiency and impaired transportation. The characteristic of his medication is that the amount of symbolic wind herbs varies according to the therapeutic purpose and the patient's Qi, but overall, he emphasized a light dosage to protect the spleen and stomach. The representative formula is Shengyang Sanhuo Tang (升阳散火汤).

Key words：stagnant fire; wind herbs; LIU Wansu; LI Dongyuan; Huo Yu Fa Zhi; spleen and stomach theory

发布时间：2026-01-08

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