基于“一气周流”理论探讨补阳还五汤治疗气虚血瘀型中风偏瘫的作用机制研究

Based on the “One-Qi Circulation” Theory: A Study on the Mechanism of Buyang Huanwu Decoction in Treating Hemiplegia Due to Qi Deficiency and Blood Stasis in Stroke

摘要: 本文基于清代名医黄元御“一气周流”理论，探讨气虚血瘀型中风偏瘫的病机机制。通过分析“一气周流，土枢四象”的核心框架，阐述中焦脾土作为轴心的关键作用，以及肝木左升、肺金右降、心火在上、肾水在下的圆运动模式。结合气虚血瘀型中风偏瘫的临床表现与诊断要点，深入分析中土虚衰、肝木郁滞和肾水失衡在气虚血瘀型中风发病中的核心作用机制，揭示气机升降失常与气血逆乱的内在联系。研究表明，从“一气周流”理论视角解析气虚血瘀型中风偏瘫的病机，可为临床治疗提供新的理论依据和思路。

Abstract: This study builds upon the “One-Qi Circulation” theory proposed by the renowned Qing Dynasty physician Huang Yuanyu to elucidate the pathogenic mechanisms of hemiplegia caused by qi deficiency and blood stasis in stroke. By analyzing the core framework of “One-Qi Circulation and the Four Symbols of Earth-Pivot,” it highlights the pivotal role of the spleen (Earth) as the central axis, along with the circular dynamic pattern characterized by liver wood rising from the left, lung metal descending from the right, heart fire residing above, and kidney water operating below. Combining clinical manifestations and diagnostic criteria of this condition, the research thoroughly examines the fundamental mechanisms involving spleen deficiency, liver wood stagnation, and kidney water imbalance in disease progression, revealing the intrinsic connection between dysregulated qi movement and chaotic qi-blood dynamics. The findings demonstrate that interpreting the pathogenesis of hemiplegia due to qi deficiency and blood stasis through the lens of the “One-Qi Circulation” theory provides novel theoretical foundations and insights for clinical treatment.