pathogenesispthogenesispathogenesispathogenesis.ppt

（一） 风气内动 wind stirring internally 风气内动—“内风” —与肝的关系较为密切，故又称肝风内动或肝风 internal wind is closely related with liver—liver wind 内风—疾病发展过程中，因为阳盛，或阴虚不能制阳，阳升无制，出现动摇、眩晕、抽搐、震颤等类似风动的病理状态 During the development of diseases, yang ascending without control due to yang excess or yin deficiency failing to balance yang will appear abnormal moving, dizziness, convulsion, and trembling （1） 肝阳化风—阳升无制而化风 yang ascending without control 病因 1. 情志所伤，肝郁化火而亢逆 emotional impairment changing to liver fire 2. 暴怒伤肝，肝气亢逆 liver qi reverse ascending due to rage 3. 操劳过度，耗伤肝肾之阴，水不涵木，阳升风动 water fails nourish liver 病症 1. 肝阳上亢证 syndrome of liver yang ascending 2. 筋惕肉瞤、肢麻震颤、眩晕欲扑、口眼歪斜、半身不遂—突然昏仆 （2）热极生风—热盛伤津耗液，筋脉失养而动风 heat produce wind 病因—热性病极期，火热亢盛，热灼津液 excessive heat consuming body fluid —热—高热、神昏、谵语 high fever, unconsciousness, delirium —灼—痉厥、抽搐、鼻翼煽动、目睛上吊 convulsion, staring eyes 病症 （3）阴虚动风—阴津枯竭，失养筋脉，化生内风 yin fails to nourish 病因 1. 热病后期，阴气大亏 consumption of yin qi 2. 久病耗津，阴气亏虚 deficiency of body fluid 津伤失濡，虚不制阳yin deficiency fails to control yang 病症 津伤—筋挛肉瞤、手足蠕动 spasm of muscles, trembling of limbs 虚热—低热起伏、舌光少津、脉细 lower fever, mirror tongue, thread pulse （4） 血虚生风—肝血亏虚，筋脉失养，化生内风 liver blood def. 病因 1. 生血不足或失血过多 less production of blood, loss of blood 2. 久病耗血，肝血不足，筋脉失养 chronic diseases consume blood 病症—肢体麻木不仁、筋肉跳动、手足拘挛不伸 numbness, spasm, convulsion （二）寒从中生 cold produced internally 内寒—阳气虚衰，温煦功能减退而化生的病理状态 yang qi deficiency failing to provide warming function 病因 1. 先天禀赋不足，肾阳素虚 congenital def. constitutional def. 2. 久病伤及脾阳 chronic diseases impairing yang 3. 外寒，生冷，损伤阳气 cold evil and food impairing yang 病症 病机—脾肾阳虚至关重要—尤其肾阳—“诸寒收引，皆属于肾” 内、外寒之异 内寒—以虚为主，虚而有寒 deficiency with cold, mainly in deficiency 外寒—以寒为主，属实寒（但寒伤阳也有虚象） cold impairing yang with def. 外寒—伤阳—阳虚证—易感外寒 external cold leads to yang deficiency 阳虚不制阴，阴寒内盛 1. 阳气不足，失于温煦—畏寒喜热、肢末不温、舌淡胖、苔白滑、 脉沉迟 aversion to cold , cold limbs, fat tongue, white coating, slow pulse 2. 气化功能减退津代障碍—水湿、痰饮 phlegm retention 3. 阳不化阴，蒸化无权，津液不化—尿频清长、涕、唾、痰涎稀薄清冷，便溏、水肿 water or, clear u