| 摘要: |
| 通过研究清代杰出医家陈士铎的医学著作，可以发现陈氏将痿证分为五痿，分属五脏，核心病机在于阳明胃火炽盛，并且会熏肺、冲心、伤脾、损肝、害肾。其从五行生克制化角度分析痿证发病的病理过程，说理透彻，同时重视各脏腑在痿证中的发病作用，将其置于整体观和恒动观中进行系统性考虑，创立了泻胃火、补肺气、养肾水、益脾阴、平肝火等众多治法。治疗上，陈士铎常用甘寒凉润之品，喜重用主药，重视各药物之间的配伍规律，善用对药，总结前人经验，自创数方，其在临床上辨证精细，用药精当，立方稳实的风格对指导现代临床有着极高价值。 |
| 关键词: 痿证 阳明胃火 肾水 陈士铎 |
| DOI：10.11656/j.issn.1673-9043.2026.08.02 |
| 分类号:R249 |
| 基金项目: |
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| Analysis of impotence diagnosis and treatment based on CHEN Shiduo’s theory of “Yangming stomach fire” |
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SUN Zhigang1, LIU Leilei2, WANG Ruochong2, SHI Lijie1
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1.Department of Gastroenterology, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China;2.School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
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| Abstract: |
| By studying the medical works of the distinguished Qing Dynasty physician CHEN Shiduo，it can be found that he divided flaccidity syndrome(wei syndrome) into five types corresponding to the five zang organs，with the core pathogenesis lying in the exuberance of yangming stomach fire，which can scorch the lung，flush the heart， injure the spleen，damage the liver，and harm the kidney. Chen analyzed the pathological process of flaccidity syndrome from the perspective of the five-phase generation and restriction cycles，providing thorough reasoning. He emphasized the pathogenic role of each zang organ in flaccidity syndrome，placing them into systematic consideration within the holistic view and dynamic perspective，and created numerous therapeutic methods， including draining stomach fire，supplementing lung qi，nourishing kidney water，replenishing spleen yin，and calming liver fire. In terms of medication，CHEN frequently used sweet，cold，cool，and moistening herbs，preferred to emphasize the principal drug，valued the compatibility rules among various medicals，and made good use of paired herbs. He summarized previous experience and created several original formulas. His style of precise syndrome differentiation，appropriate medication，and stable prescription formulation is of great value in guiding modern clinical practice. |
| Key words: flaccidity syndrome yangming stomach fire kidney water CHEN Shiduo |
