阳气不足的症状是什么?

作者: 人可工作室 分类: 保健调理,更新… 发布时间: 2020-10-15 15:38

 

阳气不足的症状是什么?大部分人都会认为阳气就是热量,所谓不足就是身体热量的不足,主要表现为身体畏寒怕冷的症状。实际上,阳气不足并不是这么简单的病证,首先,要搞清楚三方面的问题。

①阳气是什么?

②阳气不足的病因是什么?

③阳气不足的症状是什么?

了解阳气正常的功能以及导致阳气不足的原因,才可以正确的分析出阳气不足的症状。

 

一、什么是阳气

“阳气”是中医学用语,与阳气相对应的是阴血,中医认为阳气阴血是形成生命的必要条件,例如父母的精卵结合代表着阳气和阴血的凝聚,生命体由此诞生。

阴阳交媾,胎孕乃成——元•朱丹溪

阳气指人体生命活动的功能体现,而阴血是指人体生命活动的物质基础,二者互为根本,互相滋养,阳气以能量的形式表现出来,推动脏腑实现其生理功能,来化生气血津液;气血津液作为物质基础为阳气提供动力来源。阳气、阴血在动态下实现相对的平衡,达到激发维持人体的脏腑功能,化生气血津液的生命功能体现。中医学将人体的精神状态,生理活动(包括心脏搏动,胃肠蠕动,免疫功能等)归类于阳气的功能。阳气在人体中起到重要的主导地位,外在的运动体现为精神意识以及保护人体免受风寒等外邪的侵袭。内在的运动形成激发脏腑功能,推动气血营养筋脉皮骨的动力作用。随着年龄的增长,受外界各种致病因素的影响,阳气易被消耗而出现不足的表现。

阳气者,精则养神,柔则养筋——《素问•生气通天论》

 

1.阳气的具体分类和生理功能

根据阳气不同的生理功能和运动形式,可分为元气,宗气,营气,卫气。

①元气

元气是生命的本源之气,中医认为是先天禀赋与生俱来的气,具有推动人体发育,促进脏腑经络生成的作用。藏于“命门”,多数医家根据《难经》的理论,认为命门存在于右肾。元气起于命门,巡行于三焦,而发挥其生理作用。

元气,五脏六腑之本,十二经脉之根,呼吸之门,三焦之原——《难经》

元气存在于右肾之中,肾为水火之宅,左肾藏阴,右肾藏阳,肾中阳气可代指元气。元气相当于现代医学的基因遗传,受先天影响因素较大,中医认为,元气禀赋的强弱,对后天的体质,发育情况,乃至于寿命具有主导地位。例如,先天元气充足,体质多为平和体质,很少生病,保养调护得当,多可获得长寿。

元气也。视之不见,求之不得,附于气血之内,宰乎气血之先。其成形时,已有定数——《医学源流论》

若先天元气不足则多表现为小儿发育迟缓,囟门晚闭,小儿遗尿等;成年人元气不足可表现为体弱多病,尿频遗尿,慢性咳喘,女性月经不调等。

 

②宗气

宗气是元气的运行延伸至胸部,是后天呼吸自然界的清气与元气结合而积聚于胸中的气,依靠脾胃的气血精微不断的滋养,作用是助肺升提而呼吸,助心搏动血脉。

宗气者,积于胸中,出于喉咙,上走息道,而行呼吸焉——《黄帝内经》

宗气具有帮助心肺实现呼吸和心跳的作用,古代医家称宗气为胸中大气,认为气的位置高悬于上部,与肺呼吸和心推动血脉息息相关,有着重要的生理功能。

五脏六腑,大经小络,昼夜循环不息,必赖胸中大气,斡旋其间——《医门法律》

宗气不足时,患者常表现为气短乏力,心悸胸闷,严重者可出现宗气下陷,大汗淋漓,喘憋欲脱。医学家张锡纯认为宗气就是胸中大气,并根据这个观点制定了升提大气的治则治法。

大气者,原以元气为根本,以水谷之气为养料,以胸中之地为宅窟者也。司呼吸之枢机,此气一虚,呼吸即觉不利,气虚而且陷,或下陷过甚者,其人即呼吸顿停——《医学衷中参西录》

 

③营气与卫气

二者常相对而言,营气是由脾胃运化过程中所产生的气,脾胃消化饮食水谷,清的部分上升,浊的部分下降,清气中的精微柔和的气,运行于血脉内,可以助血液生成叫做“营气”;

卫气的来源主要依靠下焦的阳气。下焦的肾与膀胱属于水脏,《内经》说:“膀胱者,州都之官,津液藏焉气化则能出矣”,意思是肾中阳气蒸腾气化膀胱内的津液,水火交蒸,阳气飞腾,这一部分自下而上循三焦上行,至中焦,由脾胃运化的精微物质继续滋养,运行剽悍滑利,至上焦后,肺气宣发肃降布散于周身,调节毛孔开合,控制汗液分泌。

上焦开发,宣五谷味,熏肤充身,泽毛,如雾露之溉——《黄帝内经》

另一部分经膀胱经脉运行周身,膀胱经脉自眼睛经头至足,走行于全身。起到保卫人体,防止外邪侵袭,张仲景的《伤寒论》中提到的“太阳病”,大概就是肌表卫气受邪的疾病,太阳经脉就是膀胱经。

营出中焦,卫出下焦——《黄帝内经》

营气行于血脉之中,卫气运行于血脉之外,营气化生气血营养全身,卫气具有保护人体,免受风寒等外邪侵袭,调节毛孔开合作用的气,叫做“卫气”。

谷入于胃,以传与肺,五脏六腑,皆以受气,其清者为营,浊者为卫,营在脉中,卫在脉外——《黄帝内经》

 

脾胃虚弱,常导致营气不足,营气不足就会出现血液生成减少,引发心悸头晕,面色萎黄等血虚表现;当肾阳不足不能气化津液或脾胃虚弱不能滋养卫气或肺阳不足不能宣散卫气,皆可导致卫气不足,失去了温养皮肤肌肉,保护人体的作用,就会出现毛孔开合不利,自汗怕冷,容易感冒等,注意,由于卫气的生成和功能离不开肺,脾,肾三脏,临床上。要辨别哪个脏出现了失调导致的卫气不足,辨证论治才是王道。

血脉内外的营卫阴阳不和,则会出现营气虚弱,津血外泄,卫气受邪,毛孔开放导致自汗,头痛,怕冷的表现。

卫气者,所以温分肉,充皮肤,肥腠理,司开合者也——《黄帝内经》

2.阳气的作用体现

 

①温煦和气化作用

阳气具有温暖的特性,犹如天空中的太阳,丽日当空照耀大地,助推万物的生长发育。人体的阳气具有温曛内外的作用,人体的皮肤温度和抗寒能力都是阳气的作用体现,所以,中医学认为阳气具有温煦脏腑,经络,四肢筋骨,皮肉毛窍的作用。所谓“阳气流行,无处不到”。

阳气以升降出入的运动形式,推动人体的新陈代谢,例如饮食变化成气血精微,糟粕顺降排出体外,天气炎热人体通过出汗的散热等均是气化作用,《内经》说:“天暑衣厚则腠理开,故汗出”,腠理就是指毛孔,汗出就是阳气气化作用的体现。

阳气者,若天与日,失其所则折寿而不彰——《素问•生气通天论》

阳气不足,温煦功能下降可发生周身怕冷,手足不温:阳气不能温通血脉,常出现舌淡有瘀斑,脉涩滞;阳气不能温煦体液,津液停滞形成水饮病证,治疗时选择助阳化气的温热药物来提升阳气,温化水饮。

病痰饮者,当以温药和之——《金匮要略》

②推动激发作用

这个作用主要通过阳气分类中的元气来实现,先天禀赋的元气充足,人体脏腑经络发育正常,生殖功能完善,气血充足。精神,气色,体态较好,体质平和。因元气先天禀赋不足常出现发育情况迟缓,智力较低等。因后天消耗过度,例如饮酒熬夜,过度劳累,情绪大起大落势必消耗人体元气,就会发生须发早白,脏腑功能下降,例如脾肾两虚,腹泻便溏,腰酸腿软,乏力没精神,男性尿频,女性月经不调等。

 

③防御作用

中医认为阳气具有保护人体的作用,相当于现代医学的免疫防御,主要是通过卫气来实现其防御作用,中医将自然界的过强气候或者非时不正之气定为外邪,风寒暑湿燥火为常见的致病外邪,人体的血脉之外皮肉之间运行着保卫人体的气—卫气,卫气是阳气的一种外在体现,具有保卫人体免受外邪,同时调节可皮肤温度,控制毛孔开合。

阳者,卫外而为固也——《黄帝内经》

综上所述,阳气是人体生命活动的原动力,表现形式不同分为元气,宗气,营气,卫气,组成了中医的生理学,接下来我们再谈谈阳气不足的发生原因。

 

二、阳气不足的病因

先天不足,年老久病,过劳伤阳

先天禀赋不足,多见于未足月的新生儿或者患有遗传性疾病的小儿,先天阳气衰少,小儿免疫功能常常下降,易患各种疾病或先天形成阳虚体质,即便没有发生疾病,多表现为体弱怕冷,尿频腹泻,精神不振。随着年龄的增长,进入老年阶段人体的脏腑功能势必下降,这就是阳气随着年龄而消耗的体现,中医认为心肾阳气为一身阳气的根本,当人体进入老年阶段,阳气不能推动激发脏腑功能,所以,老年人多以退化性疾病为主要表现,例如心功能不全,前列腺炎,老年痴呆等。

身体基础差,慢性疾病较多者,阳气亦被消耗,抗病能力和康复能力下降,肾中阳气被疾病所消耗,常导致病情反复,缠绵不愈。张景岳认为“五脏之伤,穷必及肾”,有一定的道理。

负重过大,思虑过度,房事过度均是过度劳累的表现,过劳易导致阳气消耗而不足。

劳则气耗——《黄帝内经》

★感受寒邪,损伤阳气

寒邪是阴邪,《内经》说“阴盛则阳病”,寒邪过强最易损伤阳气,例如冒雨受寒,或长期居住寒湿较重的室内,极容易造成寒邪损伤肌表卫气,卫气受损后,人体的阳气随之衰少,产生阳气不足的问题。过食生冷的食物易损伤人体的脾胃阳气,而出现脾胃阳气不足的表现。

阳虚则外寒,寒必伤阳也——《景岳全书》

寒邪损伤阳气,阳虚易受寒邪,二者互相影响。

 

三、阳气不足的症状是什么?

阳气不足又叫阳虚证,属于中医学的证候范畴。值得注意的是,阳气不足证并非是某种疾病的概念,相反,阳气不足可造成多种疾病。中医理论中,阳虚有广义和狭义之分,广义的阳气不足泛指全身的阳气衰少,失去了温煦激发人体功能活动的作用,从而表现出精神萎靡不振,乏力,手足不温等症状;狭义的阳气不足指人体特定的脏腑的出现了阳气亏损,而反应出相应的临床表现,例如心阳气不足,不能温通血脉从而发生心悸胸闷,气短怔忡,不能温煦周身,则畏寒肢冷;肾阳气不足,不能温养腰肾,因“腰为肾之府”,而出现腰膝酸软,尿频遗尿。

由于中医的思维是整体观念,将人体看待为有机的整体,一个脏腑的阳虚可影响整个身体,具有“牵一发动全身”的特点。

阳虚的基本病机是:

凡阳虚之人,阴气自然必盛——郑钦安《医理真传》

阳虚的症状表现:

★全身症状:全身怕冷,手足不温,反应迟钝,精神不振,少气懒言,倦怠乏力,面色苍白,阳气推动作用下降出现便秘,阳气温煦能力下降可发生腹泻,具体情况要辨证分析。张仲景认为阳气不养精神,不能温通血脉,可出现“脉微细,但欲寐”,似睡非睡,朦朦胧胧的状态。

当阳气不足时,虚弱的阳气容易上浮于上焦或体表,可表现出燥热潮热,眼睛不舒,面红头胀,口干等表现,不要误认为是阴虚火旺,此时的脉象非常关键,如果脉象数中具有微细表现,且口干不欲饮水,就要谨慎阳气不足的假象。

 

★各脏腑阳虚的症状

①心阳气不足

心主血脉,为五脏六腑之大主,阳气不足无法振奋心脏,温通血脉,出现心悸胸闷,心慌气短,手足不温,舌淡或青紫,脉细微或迟。

②肾阳气不足

肾阳不足,不能气化推动,出现腰膝酸软,尿频遗尿,记忆力减退,浮肿畏寒,舌淡苔水滑,脉沉细。肾阳气不足,元气亦亏损,出现未老先衰,须发早白,耳鸣耳聋,头晕,失眠等。

③脾阳气不足

脾阳不足,失去了激动动力,脾胃虚弱不能运化水谷,出现腹胀,食少胃痛,受寒加重,手足不温,阳气不能推动气化津液,出现寒湿表现,大便粘腻,周身困倦,头脑不清,咽喉有痰,舌淡苔薄或腻,脉濡缓。脾阳气不足导致营气虚弱,不能变化气血,出现乏力头晕心悸,失眠等气血不足的表现。

④肺阳气不足

肺阳气不足,胸中宗气也不足,不能宣发肃降,无法主气司呼吸,出现咳喘,呼吸困难,手足冰冷,舌淡苔薄,脉缓涩。

四、阳气不足易引发的疾病

阳气不足是全身性问题,可造成多种慢性疾病,当然了,这需要中医的辨证分别,如果具备了之前谈的阳气不足的核心表现,基本可以很好的判断是否存在阳气不足。注意,以下疾病中可由阳气不足造成,也可由其他原因所引发,临床上,应该加以辨别。

常见的疾病有:

 

慢性心功能不全

老年慢性心功能不全,大多是阳气不足造成的,阳气失去了气化,推动的能力,表现为心悸胸闷,浮肿畏寒,尤其是怕冷,手足冷的表现,尿频腰酸,腹胀心口憋闷,阳气不能推动血脉,出现口唇青紫,这种情况大多与心肾阳气不足有关,注意辨证,加以区分,并对证治疗。

类风湿性关节炎或骨关节炎

此类疾病中医称为“痹症”,痹症有闭阻不同的意思,内经说“风寒湿三气杂至,合而为痹”,如果是典型的寒伤阳气,就可以判断为阳气不足,受寒引发。表现为关节肿胀疼痛,遇冷加重,舌淡苔薄脉弱。

痹症也可能由湿热引起,不属于阳气不足的问题。

甲状腺功能减退

甲状腺可以合成释放甲状腺素,甲状腺素具有维持人体心脏,神经兴奋性的激素,其功能与阳气类似,若甲状腺功能减退,表现为怕冷,反应迟钝,浮肿,可判断为阳气不足,如果辨证明确,采取针对性治疗,患者往往会收到良好的效果。

痛经

年轻的痛经患者,大多是先天禀赋的阳气不足,导致宫寒,寒性凝滞,不通则痛。痛经可分为原发性和继发性,所谓原发性是不明原因发生的经期腹痛,继发性可由子宫内膜异味,子宫腺肌症或子宫内膜炎引发。此类疾病,若出现小腹冰冷,经期腹痛,经期腹泻等阳气温煦能力下降的表现,均可按照阳气不足论治。

此外,功能性消化不良,胃动力下降等多由阳气不足所引发。由于阳虚病证引发的疾病较为广泛,不能一一列举,请读者注意辨别,必要时请中医师辨证区分,不可自行滥用药物扶助阳气。

 

总结

阳气包含着元气,宗气,营气,卫气,虽然各有其生理功能,但是总称为“阳气”,而阳气不足是中医临床的证候,多与年老久病,过劳受寒等消耗因素有关,症状表现为阳气的温煦,激发,推动,防御的能力下降,从而出现怕冷畏寒,面色苍白,尿频遗尿,便溏腹泻。临床上可引发多种疾病,例如心功能不全,痛经,甲减等疾病,当出现这些疾病和症状时,首先要请医师确认,采取规范和针对性的调整,如果先天禀赋阳气不足,但并没有实质性疾病,可咨询中医师并给予调整。关注阳气不足,相当于关爱身体,良好的生活习惯,适当的运动,健康的饮食结构,粗茶淡饭,热热乎乎,不过度劳累,按时休息,不消耗阳气,达到中医所说的“阴平阳秘,精神乃治”的健康状态!

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