Li Dongyuan proposed the theory of "fire and original qi incompatibility" in his book Piwei Lun, expounding the incompatible relationship between yin fire and original qi. They restrain and overcome each other. The rise and fall of original qi and yin fire is of great significance in the occurrence and development of ischemic stroke. When the original qi of the body is deficient and the yin fire is blazing in the interior, the internal wind moves and rushes straight to the brain to cause stroke. The key pathogenesis of ischemic stroke in the acute period is the excessive internal accumulation of yin fire, which is primarily manifested as fire-heat, phlegm stasis, and other excess syndromes during this period. As the disease progresses, the trend of yin fire gradually declines, the excess fire dies down, and deficiency fire gradually appears. Although the syndrome of excess has not disappeared, the deficiency of original qi is the most important pathogenesis in the recovery period and sequelae phase after ischemic stroke. Based on this, our team proposed the therapeutic principle of purging yin fire and tonifying original qi. According to the different pathogenesis focuses in different periods, the appropriate treatment method should be selected. In the acute period of ischemic stroke, the emphasis is on purging the excess yin fire, and the original qi will be protected when the yin fire is purged. In the recovery and sequelae periods, the original qi should be mainly tonified, and the kidney should be replenished to tonify the original qi. When original qi is abundant, yin fire will be restrained. At the same time, other treatment method should also be combined according to the syndrome differentiation to improve the therapeutic effect. This article explores the pathogenesis and treatment of ischemic stroke based on the theory of "fire and original qi incompatibility", with the aim of providing new ideas for the clinical treatment of ischemic stroke.

ischemic stroke;yin fire;original qi