[1]屈满娇,张天骄,杨嘉明,等.基于“少火生气”与“壮火食气”从五脏论特发性矮身材病机与辨治[J].陕西中医,2025,46(9):1238-1242.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.017]
　QU Manjiao,ZHANG Tianjiao,YANG Jiaming,et al.The pathogenesis and syndrome differentiation of idiopathic short stature according to the five zang organs based on the principles of “Proper fire encouraging qi” and “Excessive fire consuming qi”[J].,2025,46(9):1238-1242.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.017]
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基于“少火生气”与“壮火食气”从五脏论特发性矮身材病机与辨治

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年9期
页码:
1238-1242
栏目:
学术探讨
出版日期:
2025-09-05

文章信息/Info

Title:
The pathogenesis and syndrome differentiation of idiopathic short stature according to the five zang organs based on the principles of “Proper fire encouraging qi” and “Excessive fire consuming qi”
作者:
屈满娇; 张天骄; 杨嘉明; 罗雨薇; 郭兴旺; 刘玉清
（北京中医药大学东直门医院儿科，北京 100700）
Author(s):
QU Manjiao; ZHANG Tianjiao; YANG Jiaming; LUO Yuwei; GUO Xingwang; LIU Yuqing
(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
关键词:
少火生气; 壮火食气; 特发性矮身材; 病因病机; 辨证论治; 五脏
Keywords:
Proper fire encouraging qi; Excessive fire consuming qi; Idiopathic short stature; Etiology and pathogenesis; Differentiation and treatment; Five zang
分类号:
R 729
DOI:
DOI:10.3969/j.issn.1000-7369.2025.09.017
文献标志码:
A
摘要:
特发性矮身材（ISS）也称为特发性矮小，目前的临床治疗方案以生长激素治疗为主。中医治疗可拓宽生长激素治疗的局限性，并在一定程度上提升临床疗效。根据《素问·阴阳应象大论》中“少火生气”与“壮火食气”的理论观点，结合小儿体质特点及五脏辨证阐述ISS病因病机与辨证用药原则。以“少火、壮火失衡”为ISS核心病机。脾肾不足为本，心、肝、肺阴阳失衡为标。辨证施治时需调和阴阳，兼顾五脏。少火充沛，阴液充足，壮火平复，则五脏调和，周身四末得以温养，骨髓充盈，骨骼得养，身高增长。同时也需结合小儿生长节律特点择时用药，可更大程度发挥药效。
Abstract:
Idiopathic short stature (ISS),also known as idiopathic dwarfism,is currently treated primarily with growth hormone therapy in clinical practice.Traditional Chinese Medicine (TCM) can address the limitations of growth hormone therapy and improve clinical outcomes to some extent.Based on the theoretical concepts of “Proper fire encouraging qi” and “Excessive fire consuming qi” from the Plain Questions:The Great Treatise on Yin-Yang Correspondences,combined with the constitutional characteristics of children and the differentiation of syndromes according to the five Zang organs,this article elucidates the etiology,pathogenesis,and principles of syndrome differentiation and treatment for ISS.The core pathogenesis of ISS can be the “imbalance between mild fire and intense fire”.The root cause is insufficiency of the spleen and kidney,while the manifestations involve Yin-Yang imbalances in the heart,liver,and lung.During treatment,it is essential to harmonize Yin and Yang while considering the functions of the five Zang organs.When proper fire is abundant,Yin fluids are sufficient,excessive fire is subdued,and the five Zang organs is harmonized,the limbs and extremities are warmed and nourished,the marrow is replenished,the bones are strengthened,and height growth is promoted.Additionally,timing medication administration according to the growth rhythm characteristics of children can maximize the efficacy of the treatment.

参考文献/References:

[1]中华医学会儿科学分会内分泌遗传代谢学组.矮身材儿童诊治指南[J].中华儿科杂志,2008,46(6):428-430.
[2]应艳琴,梁雁.儿童特发性矮身材的遗传学机制进展[J].中国实用儿科杂志,2023,38(11):818-822.
[3]中华医学会儿科学分会内分泌遗传代谢学组,中国医师协会青春期健康与医学专业委员会,福棠儿童医学发展研究中心,等.儿童特发性矮身材诊断与治疗中国专家共识[J].中国实用儿科杂志,2023,38(11):801-813.
[4]王伟群,孙红,章首苑.四君子汤联合中药助长贴对矮身材儿童生长发育及骨龄的影响分析[J].中华中医药学刊,2023,41(8):63-65.
[5]万全.幼科发挥[M].北京:人民卫生出版社,2006:148.
[6]刘昌燕,陈继寅.中医儿科师承讲记[M].北京：中国医药科技出版社,2013:94-95.
[7]中医出版中心.黄帝内经素问[M].北京：人民卫生出版社,2012:9-10,13,16,22-23,109.
[8]王冰注.黄帝内经[M].北京：中医古籍出版社,2003:18.
[9]李中梓.医宗必读[M].北京：人民卫生出版社,2006:160.
[10]李东垣.内外伤辨惑论[M].北京：中国医药科技出版社,2019:31.
[11]张景岳.类经[M].太原：山西科学技术出版社,2013:405.
[12]唐容川.唐容川医学全书[M].太原：山西科学技术出版社,2016:50.
[13]马莳.黄帝内经注证发微 上[M].北京：中医古籍出版社,2017:332.
[14]张锡纯.医学衷中参西录[M].太原：山西出版集团,2009:8,338.
[15]冯兆张.中医非物质文化遗产临床经典名著 冯氏锦囊秘录[M].北京:中国医药科技出版社,2011:78.
[16]吴谦.医宗金鉴[M].北京：中医古籍出版社,2023:589.
[17]黄元御.四圣心源[M].北京：中国医药科技出版社,2020:8.
[18]缪希雍,田代华,田鹏.先醒斋医学广笔记[M].天津:天津科学技术出版社,2003:33.
[19]黄元御.素灵微蕴[M].北京：中国中医药出版社,2015:47,88.
[20]王朝.叶进教授治疗不同年龄分期矮身材儿童的经验[J].中医儿科杂志,2023,19(2):19-22.
[21]贾所学.脏腑性鉴[M].北京：中国中医药出版社,2016:19.
[22]缪希雍.神农本草经疏[M].北京：中医古籍出版社,2002:32.
[23]吴燡.医学辑要[M].北京：中国中医药出版社,2015:2.
[24]中医出版中心.灵枢经[M].北京：人民卫生出版社,2012:67.
[25]王绍隆.医灯续焰[M].北京：中国中医药出版社,2017:176.
[26]王肯堂.证治准绳[M].北京：中国中医药出版社,1997:1596.
[27]何潇潇,叶进.叶进从脾肾论治儿童矮身材[J].江西中医药,2022,53(2):26-28.
[28]余瑜,王玲.文仲渝“五脏不足有余论”治疗矮身材及偏矮儿童临证体会[J].江西中医药,2022,53(4):30-32.
[29]廖婷婷,尚莉丽.尚莉丽教授从脾为后天之本治疗儿童矮身材临床经验[J].光明中医,2023,38(17):3334-3337.
[30]孙凤平,韩雪,崔伟锋,等.从肝肾脾胃论治特发性矮身材之我见[J].中医临床研究,2017,9(3):13-15.
[31]李杲.脾胃论[M].北京：中国中医药出版社,2019:63.
[32]宋佳,闫晓凡.缪希雍《先醒斋医学广笔记》用药特色探讨[J].中华中医药杂志,2015,30(9):3361-3364.
[33]孙思邈.备急千金要方附千金翼方.[M].北京：中医古籍出版社,2022:1140.
[34]常敏毅.日华子本草辑注[M].北京：中国医药科技出版社,2016:31.
[35]国家中医药管理局《中华本草》编委会.中华本草 7[M].上海：上海科学技术出版社,1999:6753.
[36]吴仪洛.伤寒分经[M].北京：中国中医药出版社,2015:297.
[37]叶桂.临床指南医案[M].北京：中国医药科技出版社,2020:302.

备注/Memo

备注/Memo:
首都卫生发展科研专项项目课题（首发2022-2-7011）；北京中医药大学教育科学研究课题(XJY22083)
更新日期/Last Update: 2025-09-08