补中益气法学术源流、传承及当代应用

补中益气法是临床常用的治法之一。《黄帝内经》《难经》阐述了中气不足的主要临床表现,并总结出"劳者温之""损者益之"的治疗原则。《伤寒杂病论》《医学启源》为补中益气法的用药提供了依据。后世医家传承应用本法,多有创新。如李东垣用补中益气常兼顾升阳、理气、泻火、除湿、和血、养阴等加减变法,罗天益擅用灸法,王好古用以治疗外阳内阴证,薛己、孙一奎强调脾肾双补而各有特色,张景岳明确补中益气汤七禁,陈实功将本法应用于外科、补中益气、托毒外出,傅青主用以治疗妇科难证、用药剂量特色鲜明。当代医家还将本法应用于心、肝、肺、肾等各脏病证的治疗,其作用机理也逐渐被现代研究阐明。研究补中益气法的古今传承应用及作用机制,具有重要意义。

Academic origin,inheritance and contemporary application of invigorating spleen-stomach and replenishing qi method

The invigorating spleen-stomach and replenishing qi method is one of the commonly used methods in clinic.Huangdi Neijing and Nanjing expounded the main clinical manifestations of deficiency of middle qi,and they summarized the treatment principles of‘treating overstrain syndrome with warming methods’and‘treating deficiency syndrome with tonifying methods’.Shanghan Zabing Lun and Yixue Qiyuan provided the basis for the medication of invigorating spleen-stomach and replenishing qi method.There are many innovations in the inheritance and application of this method by later medical experts.For example,LI Dongyuan’s used invigorating spleen-stomach and replenishing qi method often combing with other modified methods including rising yang,regulating qi,purging fire,eliminating dampness and reconciling blood and nourishing yin.LUO Tianyi was good at using moxibustion therapy.WANG Haogu used invigorating spleen-stomach and replenishing qi m ethod to treat the syndrome of external yang and internal yin.XUE Ji and SUN Yikui,who had their own characteristics,emphasized the method of reinforce spleen and kidney together.ZHANG Jingyue clearly defined the seven prohibitions when using Buzhong Yiqi decoction.CHEN Shigong applied this method to surgery,so as to invigorate spleen-stomach and replenishing qi and help to expel toxins out of the body.FU Qingzhu applied this method to treat difficult gynecological disease,having distinctive features of dosage.Contemporary doctors have also applied this method to the treatment of heart,liver,lung,kidney and other visceral diseases,and its mechanism of action has been gradually clarified by modern studies.It is of great significance to study the ancient and modern inheritance,application and action mechanism of invigorating spleen-stomach and replenishing qi method.