摘要：在中医的浩瀚宇宙中，补土派以其独特的理论体系和实践智慧，犹如一颗璀璨的星辰，照亮了脾胃调理的道路。其中，温中健脾作为补土派的核心方法之一，更是被无数医者奉为圭臬。梁世杰主任，作为中医界的杰出代表，对温中健脾之法有着深刻的理解和独到的见解。然而，他也明确指出，温
在中医的浩瀚宇宙中，补土派以其独特的理论体系和实践智慧，犹如一颗璀璨的星辰，照亮了脾胃调理的道路。其中，温中健脾作为补土派的核心方法之一，更是被无数医者奉为圭臬。梁世杰主任，作为中医界的杰出代表，对温中健脾之法有着深刻的理解和独到的见解。然而，他也明确指出，温中健脾虽妙，但若运用不当，亦如双刃剑，可能带来不可小觑的副作用。
（一）、温中健脾：补土派的瑰宝
古语有云：“生气血于无何有之乡”，形象地描绘了温中健脾法在促进人体气血生成、增强体质方面的神奇功效。在补土派的理论体系中，脾胃被视为人体后天之本，气血生化之源。因此，温中健脾不仅能够有效缓解脾胃虚寒的症状，还能从根本上提升人体的整体机能。
梁世杰主任强调，温中健脾之法，关键在于“温”与“健”。温，即温阳散寒，以驱散脾胃之寒邪；健，即健脾益气，以恢复脾胃的运化功能。二者相辅相成，共同构成了温中健脾法的核心。
（二）、双刃剑的阴影：温补不当的三大副作用
然而，正如任何事物都有其两面性一样，温中健脾法若运用不当，亦可能带来一系列副作用。梁世杰主任将其总结为以下三大方面：
一、温燥助火，伤络动血
温燥之品，如干姜、附子等，虽能温阳散寒，但若用量过大或运用不当，便可能引发上火症状。患者可能会出现口干咽燥、舌红苔黄、便秘尿赤等表现。更为严重的是，温燥之品还可能伤及血络，导致出血倾向，如鼻衄、齿衄等。
举例：张先生因脾胃虚寒，长期服用附子理中丸。然而，一段时间后，他发现自己开始出现牙龈出血、鼻衄等症状。经梁世杰主任诊断，发现其体内火热过盛，乃是由于附子理中丸中的附子温燥之性过强所致。梁主任随即调整药方，减少附子用量，并加入一些清热凉血之品，张先生的症状才得以缓解。
二、补塞不当，壅滞中宫
脾胃为人体气机升降之枢纽。若温补不当，过于滋腻或壅滞，便可能导致气机不畅，中焦壅滞。患者可能会出现脘腹胀满、食欲不振、恶心呕吐等症状。这犹如一条原本畅通的河流被泥沙淤塞，水流变得缓慢甚至停滞不前。
举例：李女士因脾胃虚弱，求助于梁世杰主任。梁主任给予其人参健脾丸以温中健脾。然而，李女士服用一段时间后，发现自己脘腹胀满愈发严重。经梁主任诊断，发现其体内湿气较重，而人参健脾丸中的滋补之品过于滋腻，导致中焦壅滞。梁主任随即调整药方，加入一些行气利湿之品，李女士的症状才得以改善。
三、补益过早，关门留贼
在中医理论中，疾病的治疗需遵循“急则治标，缓则治本”的原则。若在外感病邪未除之时，过早使用温补之品，便可能如同关门留贼，将病邪留在体内，导致病情缠绵难愈。
举例：王先生因外感风寒，出现恶寒发热、咳嗽流涕等症状。他听闻温中健脾之法可增强体质，遂自行服用了一些温补之品。然而，他的症状并未得到缓解，反而愈发严重。经梁世杰主任诊断，发现其外感病邪未除，而过早的温补之品如同关门留贼，将病邪留在体内。梁主任随即给予其辛温解表之品以发散风寒，待外感病邪去除后，再给予温中健脾之品以调理脾胃。王先生的症状才得以彻底治愈。
（三）、结语：智慧与谨慎并重
梁世杰主任指出，温中健脾之法虽妙，但亦需谨慎用之。医者需根据患者的具体病情、体质等因素综合考虑，灵活运用各种治疗方法与药物配伍，以达到最佳的治疗效果。同时，患者亦需遵循医嘱，切勿自行盲目用药以免引发不必要的副作用。
正如一位智慧的医者所言：“医者父母心，用药如用兵。温中健脾之法虽好，但亦需用之有道。”愿每一位医者都能成为智慧的用药大师，为患者带来健康与希望。
作者简介：梁世杰 中医高年资主治医师，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京厚德为怀医生集团渐冻症研究中心主任，北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。
Three major harms of improper supplementation: Director Liang Shijie on the double-edged sword of the soil repair faction
In the vast universe of traditional Chinese medicine, the Tu Tu School, with its unique theoretical system and practical wisdom, is like a bright star, illuminating the road of spleen and stomach conditioning. Among them, Wenzhong spleen strengthening is one of the core methods of the Tu Replenishment School, and it is regarded as a model by countless doctors. Director Liang Shijie, as an outstanding representative of the Chinese medicine community, has a deep understanding and unique insights into the method of warming and strengthening the spleen. However, he also made it clear that although Wenzhong is good for strengthening the spleen, if used incorrectly, it is also a double-edged sword, which may bring side effects that cannot be underestimated.
1. Warming and strengthening the spleen: the treasure of the soil replenishing school
As the old saying goes: "The blood of life is born in the land of nothing", which vividly depicts the miraculous effect of the Wenzhong Spleen Strengthening Method in promoting the production of qi and blood in the human body and enhancing the physique. In the theoretical system of the Tu Tu School, the spleen and stomach are regarded as the foundation of the human body and the source of qi and blood biochemistry. Therefore, warming the spleen can not only effectively alleviate the symptoms of spleen and stomach deficiency, but also fundamentally improve the overall function of the human body.
Director Liang Shijie emphasized that the key to warming the spleen lies in "warmth" and "health". Wen, that is, the warmth of the yang to dispel the cold, in order to dispel the cold and evil of the spleen and stomach; Jian, that is, to strengthen the spleen and invigorate qi, in order to restore the function of the spleen and stomach. The two complement each other and together form the core of the Wenzhong Spleen Strengthening Method.
2. The shadow of the double-edged sword: three side effects of improper temperature supplementation
However, just as there are two sides to everything, if not used properly, it can also bring a series of side effects. Director Liang Shijie summarized it into the following three aspects:
1. Warmth and dryness help the fire, and the wounds move the blood
Warm and dry products, such as dried ginger and aconite, can warm the sun and dispel cold, but if the dosage is too large or used improperly, it may cause symptoms of fire. Patients may have dry mouth and throat, red and yellow tongue, constipation and red urine. What's more, warm and dry products may also hurt the blood vessels, leading to bleeding tendencies, such as epistaxis, tooth epistaxis, etc.
For example, Mr. Zhang has been taking Aconite Lizhong pills for a long time due to spleen and stomach deficiency. However, after some time, he found that he began to experience symptoms such as bleeding gums, epistaxis, etc. According to the diagnosis of Director Liang Shijie, it was found that the excessive heat in his body was caused by the excessive warmth and dryness of the aconite in the aconite Li Zhong pill. Director Liang immediately adjusted the prescription, reduced the dosage of aconite, and added some products to clear heat and cool the blood, so that Mr. Zhang's symptoms were alleviated.
Second, the plug is improperly filled, and the middle palace is stagnant
The spleen and stomach are the hubs of the body's qi machine. If the temperature is not properly supplemented, it is too greasy or stagnant, which may lead to poor qi and stagnation. Patients may experience symptoms such as abdominal distension, loss of appetite, nausea and vomiting. It's like a river that was once smooth and silted up, and the flow of water slows down or even stagnates.
For example, Ms. Li turned to Director Liang Shijie for help due to a weak spleen and stomach. Director Liang gave him ginseng spleen pills to warm and strengthen the spleen. However, after taking it for a while, Ms. Li found that her belly and abdomen were getting worse and worse. After Director Liang's diagnosis, it was found that the dampness in his body was heavy, and the nourishing products in the ginseng spleen pills were too greasy, resulting in stagnation in the middle of the spleen. Director Liang immediately adjusted the prescription and added some products to promote qi and dampness, and Ms. Li's symptoms improved.
3. Make up too early, close the door and leave a thief
In the theory of traditional Chinese medicine, the treatment of diseases should follow the principle of "treating the symptoms if it is urgent, and treating the root cause if it is slow". If you use warm tonic products too early when the external infection has not been eliminated, it may be like closing the door and leaving the thief behind, leaving the disease in the body, resulting in a lingering illness that is difficult to heal.
For example, Mr. Wang had symptoms such as chills, fever, cough and runny nose due to external cold. He heard that the method of warming and strengthening the spleen can enhance his physique, so he took some warm tonic products on his own. However, his symptoms did not relieve, but worsened. After the diagnosis of Director Liang Shijie, it was found that his external infection had not been eliminated, and premature warm supplements were like closing the door and leaving the thief behind, leaving the disease in the body. Director Liang immediately gave him Xinwen Jiebiao products to diffuse wind and cold, and after the external infections were removed, he was given warm and spleen-strengthening products to regulate the spleen and stomach. Mr. Wang's symptoms were completely cured.
3. Conclusion: Wisdom and prudence are equally important
Director Liang Shijie pointed out that although the method of warming and strengthening the spleen is wonderful, it should also be used with caution. Doctors need to consider the patient's specific condition, constitution and other factors, and flexibly use various treatment methods and drug compatibility to achieve the best treatment effect. At the same time, patients should also follow the doctor's advice and do not blindly use medication to avoid unnecessary side effects.
As a wise healer said, "The heart of the healer's parents is like using medicine as a soldier." Although the method of warming and strengthening the spleen is good, it also needs to be used in a good way. "I hope that every doctor can become a wise master of medicine and bring health and hope to patients.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently the director of the Center for Diffusion Research of Dr. Houde Wei Group in Beijing, a researcher at the Shude Tang Institute of Chinese Medicine, and a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance work station of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023.
来源：首都专家梁世杰