李东垣“阴火论”九种病机初探

从元气不足,气火失调;脾胃受损,升降失常;肾失滋养,阴火由生;肝经受病,阴火上壅;内蕴湿热,蕴而成火;脾气郁结,郁而化火;阴血不足,阴火炽盛;阳气不足,致生阴火;脾胃内伤,外邪乘虚而入等9方面对李东垣"阴火"病机的实质进行探讨。     

试论阴火

<正> 自东垣著《脾胃论》而阴火之说兴。阴火云何?为便于了解其概况,先将阴火的见证和发生的机理,分别汇集于次。一、东垣所称阴火的见证是:“气短、精神少而生火热,有时而显火独燎其面”;“其脉洪缓,更有身热,心中不便之证”;“气高而喘,身烦热,为头痛,为渴而脉洪”;“使口燥咽干”;“有时热躁”,“其皮肤不任风寒而生寒热”。二、阴火的起因及其病机:“夫饮食失节,寒温不适,脾胃乃伤。此因喜怒忧恐,损     

论东垣所创阴火为气虚之火

从李东垣论述阴火的病因病机、治则方药及用药宜忌探析,提出东垣所说的阴火即气虚之火,它的形成是体内气不足的结果。阴火用“阴”字表述的用义实是指至阴脾脏而言,脾虚则元气亦虚,气虚则火盛。     

从李东垣脾胃学说论当今糖尿病的发病与治疗

当今糖尿病的病因病机、临床表现与古代不尽相同。临床发现糖尿病病机主要包括气阴两虚,痰瘀内阻。李东垣脾胃学说认为脾胃元气不足,阴火上乘能解释糖尿病及其并发症的生成。应用东垣辛甘助阳、升阳散火、甘温甘寒除热的方法能为当今治疗糖尿病及其并发症作借鉴。     

从阴火实质探讨气虚发热的机理

从对阴火实质的分析认识来探讨李东垣提出"气虚发热"的病机,就阴火的涵义、存在形式及其与气虚发热的关系分析阐述其发病机理,认为气虚发热只是阴火证的一种表现类型之一。主要包括两个方面:一是机体的代偿性发热,可以称之为功能性发热;二是因气虚而导致的推动无力,代谢产物堆积,郁而化热、化火而发热。再结合东垣对阴火理论的论述,认为其脾胃内伤,阴火上冲的病机,也就是气虚发热的病机,实质是脾胃气虚,导致升降失常,气机阻滞于中焦,阳气郁而不得泄,转变为病理之火,继而出现火热病证。     

周永明基于"阴火"学说治疗原发免疫性血小板减少症经验

原发免疫性血小板减少症是一种获得性自身免疫性出血性疾病,历代文献中将其归为“血证”“发斑”“肌衄”等范畴,现代医学以免疫抑制剂、脾切除等治疗为主,其短期疗效显著但不持久且易反复。周永明教授通过长期临床观察发现并从中医角度总结病机特点,归纳治疗原则,辨证用药,可取得长期良好疗效。李东垣认为“内伤脾胃,百病由生”,提出了“阴火”理论。其主要内涵可概括为脾胃气虚,诸病乃生; 元气亏虚,阴火内生; 谷气下流,阴火上乘。周师运用阴火理论并有所发挥,认为脾、肾、气、火密切相关,脾气虚弱,水谷不化,先天失养,阴阳失衡,相火离位。原发免疫性血小板减少症的病机特征为脾肾亏虚、火伤血络,治疗则以健脾滋肾泻火为主,周师临证常取东垣补中益气汤之意、仲景泻心汤之意,变通运用,创立健脾补肾泻火方,取效良好。     

李东垣阴火理论探源

本文以李东垣《脾胃论》为据,探讨李东垣提出的阴火及其理论。认为阴火是在脾胃气虚及其他内伤因素影响下导致心、肝、脾、肾、心包络所产生的内火;而已生成的阴火亦会反过来去乘脾胃,从而产生“气虚生大热”等一系列病变;治疗阴火当以补脾胃升阳气为本,兼用甘寒泻火为标;代表方为补中益气汤及补脾胃泻阴火升阳汤。本文对东垣阴火理论的探讨有一定的意义。     

李东垣阴火论及甘温除热法

李东垣所论之阴火,为脾胃内伤引起体内阴阳失衡,脏腑功能失常而产生的一种内火。病机有脾胃内伤,君火不守;脾胃内伤,相火浮越;脾胃内伤,气郁化火;脾胃内伤,阳气内伏化火;脾胃内伤,湿火相合;脾胃内伤,内燥化火。各个病机相互联系,相互影响。甘温除热法为阴火之治疗大法,临证根据阴火的形成机制及病情发展不同,应用不同治法,或益气升阳,补泻共用;或益气升阳,滋水伏火;或益气升阳,疏理气机;或益气升阳,疏散邪火;或益气升阳,燥湿泻火;或益气升阳,养阴泻火。用药不仅仅拘泥于甘温之品,在采用甘温之品的基础上,明确阴火的病机,随证治之。凡是扶助正气,祛邪退热之法,均可视为甘温除热法。     

李杲“心火炽盛”机理初探

李杲在其著作中,经常提到“心火炽盛”等内容,而所谓“心火炽盛”者,是说机体发热由阴血不足、心神失养而生火。而阴血不足、心神失养又归咎于脾胃气虚、元气不足、清气不升、浊阴不降,以致气血生化失常。持此论者是以东垣的“脾胃气虚、元气不足,而心火炽盛,心火者,阴火也……盖阴火上冲则气高喘而烦热,为头痛,为渴而脉洪”作为立论根据的。这一论点虽然比较符合东垣立论制方意旨。但从脾胃气虚到“心火炽盛”而     

蔡淦教授运用“补脾胃、泻阴火”治疗胃肠病经验

蔡淦教授的学术思想体系极为推崇李东垣脾胃学说,并善用东垣脾胃学说指导治疗各种疑难疾患。"补脾胃、泻阴火"是李东垣针对内伤疾病"脾胃内伤、阴火上乘"的病机特点而制定的治法,蔡教授运用此法积累了丰富的临床经验,疗效确切。文章介绍蔡淦教授运用"补脾胃、泻阴火"治疗胃肠病的经验,认为临证重视阴火内涵,善用补脾胃、泻阴火;治脾胃内伤,可宗东垣之法则;并举慢性萎缩性胃炎和溃疡性结肠炎各一例以说明临床应用。     

Oplopanax elatus（Nakai） Nakai： chemistry,traditional use and pharmacology

Oplopanax elatus（Nakai） Nakai, a member of the ancient angiosperm plant family Araliaceae, is used for the treatment of different disorders in the medicine systems of China, Russia, and Korea, and was designated in Russia as a classical adaptogen. Despite extensive studies of classical adaptogens, there are comparatively few reports concerning the chemical composition and pharmacological effects of O. elatus in English. The plant is a potential source of saponins, flavonoids, anthraquinones, terpenes, and other active compounds. Experimental studies and clinical applications have indicated that O. elatus possesses a number of pharmacological activities, including adaptogenic, anti-convulsant, anti-diabetic, anti-fungal, anti-inflammatory, anti-oxidant, blood pressure modulating, and reproductive function effects. In this review, the chemistry, safety, and therapeutic potential of O. elatus are summarized and highlighted to encourage the further development of this plant.     

中药膏方治疗疑难杂症验案4则

所谓膏方又称膏滋方,具有治病纠偏,滋补强身等多种作用。时下在江南一带时兴冬令以膏方进补,实际上是中药传统剂型的丸、散、膏、丹、汤、酒、露、锭八种剂型之一。由于服用方便、疗效显著,在一年四季均可服用,尤其是针对一些需长期服药的慢性病或疑难顽症,更适合以膏方来调治。现代家庭多具备冰箱冷藏的条件,这为膏剂的收藏提供了方便。因此,更可以提倡以膏方剂型来治疗诸多慢性疾病。笔者常不拘季节以膏方为主,根据辨证施治原则来治疗某些疑难病症,现撷取4则医案,以飨读者,不当之处,请多赐教为盼。     

Polysaccharides from Tricholoma matsutake and Lentinus edodes enhance 5-fluorouracil-mediated H22 cell growth inhibition

OBJECTIVE： Few studies have investigated the ef- fects produced by combinations of polysaccharides and chemotherapeutic drugs in cancer treatment. We hypothesized that a combination of polysaccha- rides （COP） from Lentinus edodes and Tricholoma matsutake would improve the efficacy of 5-fluoro- uracil （5-FU）-mediated inhibition of H22 cell growth. METHODS： Mice were injected H22 cells and then treated with either 5-FU, polysaccharides from Tri- choloma matsutake （PTM）, polysaccharides from Lentinus edodes （PL）, PTM ＋ PL, 5-FU ＋ PTM, 5-FU ＋ PL, or 5-FU ＋ COR The tumor weight and volume, and splenic CD4 ＋ and CD8 ＋ T cell frequencies, were determined. Additionally, splenic natural killer （NK） cell and cytotoxic T lymphocyte （CTL） activities were assessed and the serum levels of tumor necro- sis factor-a （TNF-a）, Interleukin-2 （IL-2）, and Interfer- on-y （IFN-y） were measured. RESULTS： Compared with mice from the control,5-FU, PL, PTM, PTM ＋ PL, 5-FU ＋ PL, and 5-FU ＋ PTM groups, mice treated with 5-FU ＋ COP showed： （a） significantly reduced tumor weight and volume （P〈 0.05）, （b） significantly higher serum levels of TNF-α, IL-2, and IFN-y （P〈0.05）, （c） significantly increased CD4＋ and CD8＋ 1 cell frequencies in the spleen （P〈 0.05）, and （d） significantly increased splenic NK cell and CTL activities （P〈0.05）. The tumor weight and volume in mice treated with 5-FU＋PL or 5-FU＋PTM were significantly reduced compared with mice treated with 5-FU alone （P〈0.05）. Serum levels of TNF-α, 11.-2, and IFN-y, frequencies of CD4 ＋ and CD8＋ T cells in the spleen, and splenic NK and CTL activities were also significantly increased in mice treated with 5-FU＋PL or 5-FU＋PTM compared with mice treated with 5-FU alone （P〈0.05）. CONCLUSION： Polysaccharides from Lentinus edodes and Tricholoma matsutake could enhance the efficacy of 5-FU-mediated H22 cell growth inhi- bition.     

刘公望运用经方治疗放化疗不良反应验案2则

恶性肿瘤的致死率甚高,源自上皮组织者称为癌,源自间叶非上皮组织者称为肉瘤,二者均病情凶险,预后恶劣。目前肿瘤的治疗有外科手术治疗、放射治疗及化学治疗。在放化疗过程中往往发生毒副作用,导致患者的抵抗力下降,严重时可影响治疗的继续进行。刘公望教授巧用经方治疗放化疗后引起的毒副反应,收效良好。现举医案2则,以飨读者。     

Clinical Application of Yongquan （KI 1）Acupointd

Yongquan （KI 1） is the Jing-Well point of Kidney Meridian of Foot Shaoyin. It can be used to treat many kinds of diseases, such as parietal headache, vertigo and blurred vision, hypopharynx swelling and pain, dry tongue, voice loss, epistaxis, apoplexy and apoplectic sequela, dysufia, ungratifying defecation, epilepsy, syncope, planter fever, palpitations, lower limbs spasm, hypertension, vomiting, infantile convulsion. The author applied Yongquan （KI 1） in clinical practice and obtained satisfactory therapeutic effects. Now five cases were introduced as follows.     

Antidepressant-like effect of essential oil of Perilla frutescens in a chronic,unpredictable, mild stress-induced depression model mice

Perilla frutescens（Perilla leaf）, a garnishing vegetable in East Asian countries, as well as a plant-based medicine, has been used for centuries to treat various conditions, including depression. Several studies have demonstrated that the essential oil of P. frutescens（EOPF） attenuated the depressive-like behavior in mice. The present study was designed to test the anti-depressant effects of EOPF and the possible mechanisms in an chronic, unpredictable, mild stress（CUMS）-induced mouse model. With the exposure to stressor once daily for five consecutive weeks, EOPF（3, 6, and 9 mg·kg-1） and a positive control drug fluoxetine（20 mg·kg-1） were administered through gastric intubation to mice once daily for three consecutive weeks from the 3rd week. Open-field test, sucrose consumption test, tail suspension test（TST）, and forced swimming test（FST） were used to evaluate the behavioral activity. The contents of 5-hydroxytryptamine（5-HT） and its metabolite, 5-hydroxyindoleacetic acid（5-HIAA）, in mouse hippocampus were determined by HPLC–ECD. Serum interleukin（IL）-1, IL-6, and tumor necrosis factor（TNF）-α levels were evaluated by enzyme-linked immunosorbent assay（ELISA）. The results showed that CUMS significantly decreased the levels of 5-HT and 5-HIAA in the hippocampus, with an increase in plasma IL-6, IL-1β, and TNF-α levels. CUMS also reduced open-field activity, sucrose consumption, as well as increased immobility duration in FST and TST. EOPF administration could effectively reverse the alterations in the concentrations of 5-HT and 5-HIAA; reduce the IL-6, IL-1β, and TNF-α levels. Moreover, EOPF could effectively reverse alterations in immobility duration, sucrose consumption, and open-field activity. However, the effect was not dose-dependent. In conclusion, EOPF administration exhibited significant antidepressant-like effects in mice with CUMS-induced depression. The antidepressant activity of EOPF might be related to the relation between alteration of seroto     

Effect of Zhuyeshigao granule on tumor necrosis factor-a and inter- leukins serum protein levels in rats with radiation esophagitis

OBJECTIVE： To investigate the effects of Zhuyesh- igao granule （ZSG） on tumor necrosis factor-a （TNF-a）, interleukin-1 （IL-1）, IL-2, IL-6, and IL-8 in rats with radiation esophagitis. METHODS： Fifty Wistar rats were randomly divid- ed into five groups （10 rats in each group）： con- trol （without radiation）, saline-treated, and low, medium, and high-dose ISG-treated groups. Rats were given normal saline （10 mL/kg） or 1.15, 2.3, or 4.6 g/kg ZSG by intragastric administration once a day for 7 days. A rat model of radiation esophagi- tis was established by local irradiation of Co60 （490.25 cGy/min, totaling 30 Gy）. The administra- tion of ZSG was continued for another 7 days and on the 7th day post-irradiation, inferior vena cavablood was collected. The serum was separated, and TNF-a, IL-1, IL-2, 11_-6, and IL-8 protein levels were determined. RESULTS： Inflammatory response factors were found in the serum of each group. However, levels in ZSG-treated groups were significantly lower than in the saline-treated group （P〈0.05）. CONCLUSION： ZSG may prevent the development of radiation esophagitis, perhaps by inhibiting the generation and release of the inflammatory re- sponse factors TNF-a, IL-1, IL-2, IL-6, and IL-8.     

Characteristics of Mang Needle Therapy and Its Clinical Application

Mang needle （elongated needle, 芒针） is evolved from the long needle, one kind of nine needles in the ancient times, and is primarily characterized by its long needle-body and its arrival at the deep tissues of the body. However, because of the particularity of the physiology and anatomy of some diseases, direct deep puncturing can＇t reach the due tissues, thus the treatment results are affected. Based upon the deep puncturing of Mang needle and the physiology and anatomy of the human body, professor YANG Zhao-gang, a well-known acupuncturist, has made many improvements and innovations, in his long-term clinical practice, in the manipulations and indications of Mang needle, consequently to establish a series of unique puncturing techniques of Mang needle, which work excellently on some difficult and complicated diseases. This Mang needle therapy is introduced as follows.     

Cytological and biochemical studies during the progression of alloxan-induced diabetes and possible protection of an aqueous leaf extract of Costus afer

Some plants have proven efficacy in the management of diabetes mellitus, of which Costus afer is one. This study was designed to evaluate the cytological and biochemical properties, and comparative ameliorating effects, of an aqueous extract of Costus afer Ker Gawl.（Costaceae） leaf and glibenclamide（GBM）, in liver, kidney, and pancreatic injury induced by alloxan. Thirty male albino rats were divided into six weight-matched groups. Group one served as the negative control（non-induced and non-treated, control）, while groups 2–6 were alloxan-induced diabetic groups. Group 2 served as a positive control（induced and non-treated, IC）, groups 3–5 were treated with different doses of the extract（375, 750, and 1 125 mg/kg body weight） and glibenclamide, respectively. Body weight, absolute and relative organ weights, food and fluid intake, levels of serum glucose and liver enzymes and kidney parameters were calculated and compared. Hepatocytes, renal tubules, and pancreatic cells of diabetic rats, in diabetic non-treated and treated rats were harvested and examined histopathologically. There was dose dependent amelioration on the injuries induced by alloxan on both hepatocytes, renal tubules, and pancreatic cells after treatment with Costus afer. The glucose level was reduced significantly in the Costus afer treated diabetic rats compared with the non-treated diabetic group. Costus afer leaves seem to be effective against diabetic cell injury induced in rat liver, kidney, and pancreas.     

Efficacy of Saam acupuncture treatment on improvement of immune cell numbers in cancer patients： a pilot study

OBJECTIVE： To collect preliminary data on the effects of Saam acupuncture with regard to the immunity in cancer patients.METHODS： Ten cancer patients were analyzed for improvements in immunity. Acupuncture was applied at the 5 acupuncture points, Jingqu（LU 8）, Zutonggu（BL 66）, Yanggu（SI 5）, Yangchi（TE 4）, and Zhongwan（CV 12） for 2 weeks with 4 sessions. We assessed the effect of Korean Saam acupuncture on the immune system in cancer patients by measuring particular blood cell subsets, including CD3 ＋,CD4＋, CD8＋, CD19＋, and CD56＋ cells, as well as total white blood cell count, absolute neutrophil count, and fatigue score. The measurement was performed before and after acupuncture and at a 2-week follow-up.RESULTS： There was a statistically significant increase in the number of CD3＋（P=0.023） and CD8＋ cells（P〈0.001） and T-cell subsets, as well as a decrease in the fatigue severity scale（FSS） score（P=0.001） after Saam acupuncture using the 5 acupoints.CONCLUSION： Acupuncture may improve the immune system by increasing the counts of a few immune cells and relieve fatigue in cancer patients by decreasing FSS scores. Although this was a non-controlled study, it constitutes preliminary research investigating the potential effects of Saam acupuncture in increasing the counts of several immune cells in cancer patients.