[1]薛建鑫,赵亚男,刘明,等.基于“阳化气，阴成形”探讨五苓散论治慢性下肢静脉性水肿[J].陕西中医,2026,(8):1090-1093,1124.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.014]
　XUE Jianxin,ZHAO Yanan,LIU Ming,et al.Based on Yang transforms into Qi Yin forms shape discusses treatment of chronic lower extremity venous edema with Wuling San[J].,2026,(8):1090-1093,1124.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.014]
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基于“阳化气，阴成形”探讨五苓散论治慢性下肢静脉性水肿

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1090-1093,1124
栏目:
学术探讨
出版日期:
2026-08-05

文章信息/Info

Title:
Based on Yang transforms into Qi Yin forms shape discusses treatment of chronic lower extremity venous edema with Wuling San
作者:
薛建鑫1; 赵亚男2; 刘明2; 刘航帆1; 董昕瑶1; 张玉冬2
（1.山东中医药大学第一临床医学院，山东 济南 250014；2.山东中医药大学附属医院，山东 济南 250014）
Author(s):
XUE Jianxin1; ZHAO Yanan2; LIU Ming2; LIU Hangfan1; DONG Xinyao1; ZHANG Yudong2
(1.The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,China；2.Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)
关键词:
阳化气; 阴成形; 慢性下肢静脉性水肿; 五苓散; 温阳化气; 病机; 瘀血
Keywords:
Yang transforms into Qi Yin forms shape; Chronic venous edema of the lower limbs; Wuling San; Warming Yang to transform Qi; Pathogenesis; Blood stasis
分类号:
R 256.51
DOI:
DOI:10.3969/j.issn.1000-7369.2026.08.014
文献标志码:
A
摘要:
探讨慢性下肢静脉性水肿的中医核心病机，以及五苓散对该病的辨治思路。立足中医“阳化气，阴成形”理论，分析本病“阳气不足、气化失司”导致水湿停滞的病理本质。以《伤寒论》五苓散为研究对象，从方剂配伍、性味归经及现代药理学角度，剖析其“温阳化气”与“利水逐浊”并行的治疗机理，结合典型病案验证其临床实效。本病根本在于“阳化气”功能减退，致“阴浊”有形之邪积聚。“阳化气，阴成形”精准概括了本病阳气不足、水湿内停的病机。五苓散通过桂枝通阳化气，复三焦气化之司；二苓与泽泻导水下行，给邪以出路；佐以白术健脾制水，共奏扶阳祛浊之效。现代研究表明，其能改善微循环，调节水通道蛋白，多靶点缓解静脉高压。临证化裁治疗下肢水肿，收效显著。“阳化气不足，阴成形太过”是慢性下肢静脉性水肿的关键病机。五苓散通过温阳、利水双调，实现了对水肿标本兼治的精准干预，体现了中医“病-机-证-治”一体化的诊疗优势。
Abstract:
Explores core pathogenesis of chronic lower limb venous edema from traditional Chinese medicine (TCM) perspective,as well as diagnostic and therapeutic approach using Wuling San.Based on TCM theory Yang transforms Qi while Yin forms form.It analyzes the pathological essence of this condition-namely,deficiency of Yang Qi and impaired Qi transformation leading to stagnation of water and dampness.Taking Wuling San from Shanghan Lun as the focus.Its therapeutic mechanism from perspectives of formula composition,herbal properties and meridian affinities,and modern pharmacology,highlighting its dual action of warming Yang to transform Qi and promoting diuresis to eliminate turbidity.Clinical effectiveness was verified through case studies.The root cause of this disease lies in the diminished function of Yang transforming Qi,resulting in accumulation of tangible Yin turbidity.The principle Yang transforms Qi,Yin forms form precisely captures the pathogenic mechanism of Yang deficiency and internal retention of water-damp.Wuling San warms Yang and promotes Qi transformation via Guizhi,restoring the normal function of the triple burner.Poria and Alisma,together with Zexia,guide water downward,providing an outlet for pathogenic factors.Baizhu strengthens the spleen and controls fluid retention,collectively achieving the effect of supporting Yang and eliminating turbidity.Modern research indicates that the formula improves microcirculation,regulates aquaporins,and alleviates venous hypertension through multiple targets.Clinical modifications of formula had shown significant efficacy in treating lower limb edema.Deficiency of Yang transforming Qi and excessive formation by Yin represents the key pathogenesis of chronic lower limb venous edema.Wuling San achieves precise intervention by simultaneously regulating both symptoms and root causes through warming Yang and promoting diuresis,demonstrating integrated strength of TCM’s holistic approach-disease,mechanism,syndrome,treatment-in clinical practice.

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备注/Memo

备注/Memo:
国家自然科学基金青年科学基金资助项目（82004369）；山东省自然科学基金资助项目（ZR2022MH268）
更新日期/Last Update: 2026-08-13