纯阳理论与稚阳稚阴学说的源流发展及临床意义探讨

纯阳理论与稚阳稚阴学说是中医儿科学认识小儿体质、生理、病理的两大代表性理论学说。《颅囟经》正式提出纯阳理论,认为小儿真气未耗,生长旺盛;北宋钱乙继承了纯阳理论,并发展性提出小儿易虚易寒的体质特点,认为儿科用药应注重柔润及脾胃调护,反对一味使用清凉之品,伤及小儿阳气;清代吴瑭提出稚阳稚阴学说,认为小儿幼小娇嫩,"稚阳未充,稚阴未长",易出现阳气衰微现象。后世医家在以上两种理论学说的基础上,提出小儿"脏腑娇嫩,形气未充;生机蓬勃,发育迅速"的生理特点和"发病容易,传变迅速;脏气清灵,易趋康复"的病理特点。基于以上特点,临床儿科疾病的治疗应注重调节阴阳、顾护脾胃,用药应避免峻补峻泻,寒热温凉四气、辛苦甘酸咸五味不可过用。

Exploration of the Origin and Development of Pure Yang Theory and Immature Yin and Immature Yang theory and Their Clinical Significance

In traditional Chinese medicine(TCM) pediatrics,pure yang theory and immature yin and immature yang theory are two representative theories on body constituion,physiology and pathology of the children.Fontanel Canon proposes pure yang theory,and holds that the children's genuine qi is not consumed,and their growth is prosperous. QIAN Yi,in the Northern Song Dynasty,inherited and developed the pure yang theory. He proposed that children tended to be deficiency and cold,and the medicine for the children should be tender and moisture to protect and regulate spleen and stomach,and he was against using cold and cool medicine alone,which could damage the yang qi of the children. WU Tang,in the Qing Dynasty,proposed immature yin and immature yang theory,and held that the children were so tender,"immature yang not sufficient","immature yin not developed",that the yang qi of the children tended to be deficient. Based on these two theories,doctors of later generations put forward that the physiological characteristics of the children is that the organ is tender,the body and qi is not fully developed,the growth of children is vigorous and rapid,and the pathological characteristics of the children is that disease occurrence is easy,diseases develop quickly,visceral qi is clear and swift,and the recovery is quick. Based on these characteristics,treatment of clinical pediatric diseases should be focused on regulating yin and yang,protecting and harmonizing spleen and stomach,avoiding using too strong medicine,and the four tastes and five flavors should be moderate.