以《內經》「亢害承制」原旨辨治「內傷濕熱證」

Case Report: Lowering Blood Glucose by Supplementing Kidney-Yang in a Patient Diagnosed as Type 2 DM

陳逸光(Yee-Guang Chen)

《台灣中醫臨床醫學雜誌》 20卷1期 (2014/12) Pp. 9-15

https://doi.org/10.6968/TJCCM.201412_20(1).0002

摘要

傳統中醫對「濕熱證」有外感、內傷之別，溫病學如薛生白、葉天士等名家，認為外感濕溫傷人輕者發熱、惡寒，重則神昏譫語，甚至昏迷，是從熱病急而疾的臨床病變論之。本文則從河間學派「亢害承制」之內經原旨，而論及「濕熱證」是從「內傷」言之，熱極反兼水化是夏日產生濕熱證之玄機。臨床中醫師對濕熱證必相當熟識，而濕為陰邪流連在身體可以相當之長久，脾濕所困傍晚時分神疲乏力、精神不振、胸腹痞滿，口乾不引飲等症狀，相當困頓卻又說不出個中道理，十分之苦腦，如今雖時值嚴冬，門診中偶有夏日患濕熱證者至冬未癒，而服中藥得以迅速緩解的。中醫治療「濕熱證」在唐朝《備急千金方》，即有詳細記載，歷史悠長，是相當常見之疾病，今以河間學派之理法，探求規矩以證方圓。

關鍵字

亢害 ； 承制 ； 濕熱證 ； 內傷 ； 兼化

並列摘要

In traditional Chinese medicine, the etiology of Dampness-Heat syndromes may be given by external and internal vicious. Ancient medical masters of 溫病Wen-Bing, 薛生白Xue Sheng-Bai and 葉天士Ye-Tain-Shi, gave the idea that external Dampness-Heat syndromes can be leveled from mild to severe. Mild clinical syndromes gave rise to fever and coldness, severe as delirium and coma. This kind of syndromes can be sub-categorized to acute febrile diseases. Theory of (Offensive, Impairment, Successive, Suppressive) which arose from divisions of 劉河間 Heijan gave the concept of Dampness-Heat yielded internally. They explained the reason of dampness in the summer time as overwhelming hotness which may emerge to dampness. Traditional Chinese medical doctors are familiar with treating internal Dampness-Heat syndromes. Nevertheless, dampness is a kind of Yin-evil if it hurts people who may be suffered from fatigue, tiresome, chest-tightness, abdominal fullness and thirsty without drinking desires, for a long period of time. Usually, patients feel body sickness but can not tell what is wrong with it. Although it is the winter season now, there is still patient who has been suffering from Dampness-Heat syndromes since last summer and usually cured promptly by Chinese herb remedy. Historically, Dampness-Heat syndromes had been documented since the Tang Dynasty in the Book of 《備急千金方》 Bei Ji Qian Jin Yao Fang which is over 1500 years. This kind of disease actually is commonly occurred. In this manuscript, the theory from Heijan is introduced to threat the disease and work it out as a dilemma of treatment.

並列關鍵字

Offensive-Impairment ； Successive-Suppressive ； Dampness-Heat syndromes ； Internal damage ； reversal transformation