夏季内伤发热与夏季时令特点密切相关。该文基于李东垣之阴火理论，认为夏季暑热，饮食不节，过食寒凉，起居 不慎，暑湿内侵伤脾而致阴火内生，从而引起内伤发热。夏季内伤发热的核心病机为脾虚阳陷，气机不畅，阴火内生；阴 火贯穿内伤发热的全过程。治疗当从除阴火入手，除阴火首先要从脾本论治，益气升阳以恢复脾升胃降之气机，则阴火得 散；清热祛湿以泻阴火而复脾气周流。从湿聚成痰、火热伤阴、肝郁肾虚等病机变化预测病情发展趋势，综合运用化痰、 滋阴、疏肝、补肾等法，防止病情进一步发展。基于李东垣之阴火理论，可选用升阳益胃汤（主要由黄芪、 半夏、 人参、 炙甘草、独活、 防风、 白芍、羌活、 陈皮、 茯苓、 柴胡、 泽泻、 白术、 黄连组成）为基础方，通过结合具体病情加减用 药，以治疗阴火内生所引起的夏季内伤发热。该思路探讨可为临床论治夏季内伤发热提供参考。

The prevalence of summer endogenous fever is closely related to the climate of summer. Based on Li Dongyuan’s yin-fire theory，this article proposed that summer-heat，irregular diet，excessive consumption of cold foods，poor living habits，and summer damp-heat internal invasion damaging the spleen can all lead to the generation of yin-fire，thereby causing endogenous fever. The core pathogenesis of summer endogenous fever lies in spleen deficiency with yang collapse，which results into the blockage of qi movement and the production of yinfire. The yin-fire persists throughout the entire course of the disease. Treatment of summer endogenous fever should focus on eliminating yin-fire，primarily by addressing the spleen via boosting qi and raising yang to restore the spleen’s ascending and stomach’s descending functions，thereby dispersing yin-fire. Clearing heat and resolving dampness can purge yin-fire and then the spleen qi’s circulation is restored. By analyzing the pathological changes of dampness accumulation into phlegm，fire-heat damaging yin and liver stagnation with kidney deficiency，the disease progression can be predicted. Correspondingly，comprehensive therapy of resolving phlegm，nourishing yin，soothing liver，and tonifying kidney can be employed to prevent further deterioration. Based on Li Dongyuan’s yin-fire theory，Shengyang Yiwei Decoction （mainly composed of Astragali Radix，Pinelliae Rhizoma，Ginseng Radix et Rhizoma， Glycyrrhizae Radix et Rhizoma Praeparata cum Melle， Angelicae Pubescentis Radix， Saposhnikoviae Radix， Paeoniae Radix Alba， Notopterygii Rhizoma et Radix， Citri Reticulatae Pericarpium， Poria，Bupleuri Radix，Alismatis Rhizoma，Atractylodis Macrocephalae Rhizoma，and Coptidis Rhizoma） can be used as a fundamental prescription to treat summer endogenous fever caused by yin-fire，with modifications tailored to specific clinical presentations. This theoretical exploration may provide a reference for the clinical management of summer endogenous fever.

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教育部产学合作协同育人项目（编号：230714184507236）；深圳市中医“治未病”重点专科建设项目；深圳市中医院首届医院 管理研究课题（深中医 〔2023〕 133 号）