从气化论探讨五苓散治疗水液代谢障碍疾病

水液代谢障碍的病机是脏腑功能失调,气化失司,水湿停聚,致使气血津液代谢失常而生痰、饮、水、湿、浊、毒,而病邪又进一步阻碍气机形成恶性循环。因此,鼓动阳气,温阳化饮是治疗的关键。三焦通行诸气,运行水液的功能得到历代医家的基本认同。五苓散是《伤寒论》中治疗"气化不利,水液内停"的主方,五苓散原文可治疗膀胱蓄水证、水逆证和津亏液燥证。五苓散全方温阳与化饮相结合,恢复机体气化功能,驱邪外出,使机体达到阴平阳秘的状态。全文达成病证方一条线来治疗水液代谢潴障碍疾病,从而更好地指导临床。

Treatment of Water Respiratory Metabolism Disorder with Five Substances Powder with Poria From Perspective of Qi Activity

The pathogenesis of disorder of water respiratory metabolism is irregular visceral function,failure of qi activity and water damp accumulation,making metabolism abnormity of qi,blood and body fluid and then generation of phlegm,water retention,water,dampness,turbidity,toxicity,and the pathogens further impede qi mechanism as a vicious circle.Therefore,activating yang qi,warming yang and resolving water retention are the keyto the treatment.The ideas of triple energizer transporting various qi and water are basically accepted by generations of doctors.Five Substances Powder with Pofia in Treatise on Cold Damage is the main formula to treat disorder of qi activity and internal accumulation of water.This formula can treat syndrome of water accumulation of gallbladder,water reverse syndrome and syndrome of body fluid insufficiency.It combines warming yang and resolving water retention,restores the function of qi activity and repels the pathogen outside,making the body in a yin-yang balanced state.This formula achieves a mode of disease-syndrome-formula in the treatment of disorder of water metabolism for better guidance in clinical practice.