從不明熱顯效病例談李東垣陰火診治特點

The Diagnostic and Therapeutic Features of Li Dong Yuan's Yin-Fire Theory: Taking A Case of Fever of Unknown Origin for Example

李東垣為金元時代著名醫家，他創立的陰火學說與甘溫除熱法為其重要學術思想，他認為飲食失節、勞役過度、情志不安等因素引起脾胃虛損，進而產生陰火，典型治療代表方劑為補中益氣湯。本文之病例反覆發熱，但各種檢驗與檢查都無異常，我們以此不明熱病案為例，詳述運用李東垣甘溫除熱法之治療過程，最後病患症狀獲得顯著之改善。我們更深入探討李東垣的陰火學說，以系統性的方式分析其診治特點，同時也在文中說明臨床上運用甘溫除熱法之經驗與體會。

Li Dong Yuan was a famous physician at Jin-Yuan Dynasty in China. Yin- Fire theory and the method of eliminating heat with sweetness and warmth were important academic thoughts described by Li. He noticed that dietary imbalance, over-work and emotional stress were main causes of spleen and stomach Qi vacuity. Yin-Fire was then developed from Qi deficiency of spleen and stomach. The typical therapeutic prescription is Bu-Zhong-Yi-Qi-Tang. The patient in this article had a fever on and off, however, all of his lab data, imaging, and examinations were normal. We take this case of Fever of Unknown Origin as an example, and describe the treatment process applying Li's method of eliminating heat with sweetness and warmth in detail. The patient's symptoms were markedly improved consequently. Furthermore, we not only discuss and analyze the diagnostic and therapeutic features of Li's Yin-Fire theory in a systematic way, but also elaborate our clinical experience in the use of the method of eliminating heat with sweetness and warmth.