辨识畏寒与恶寒病机的关键是卫气  

Defensive Qi: the Key to Distinguishing Pathogenesis of Fear of Cold and Aversion to Cold

作　　者：沈宏春[1,2] 罗永兵[1] 王浩中[2] 严石林[2] 

机构地区：[1]泸州医学院中西医结合学院,四川泸州646000 [2]成都中医药大学基础医学院,四川成都610075

出　　处：《南京中医药大学学报》2013年第2期109-110,共2页Journal of Nanjing University of Traditional Chinese Medicine

摘　　要：通过分析历代医书中畏寒与恶寒的含义,阐述畏寒与恶寒的用法,恶寒最初代指一切怕冷症状,宋代用畏寒部分代指外感怕冷,明清则畏寒与恶寒混用。在高等教育的中医诊断学教材中将畏寒与恶寒严格区分,怕冷这一症状,用恶寒描述的表示外感,用畏寒描述的表示内伤,对临床诊断无疑起到了一定的作用。但是认为这容易导致初学者忽略怕冷形成的机理,对一些疑难病证的诊断容易产生错误,所以提出临床上区别畏寒与恶寒,关键在于判断卫气是虚弱还是阻滞。Through the analysis of concepts of fear of cold and aversion to cold in medical books of past dynasties, it was found that with aversion to cold, referring to all cold symptoms initially, fear of cold partly meaned exogenous cold （Song Dynasty）and fear of cold and aversion became confused （Ming and Qing Dynasty）. In the diagnostics of traditional Chinese medicine textbook of higher education, fear of cold and aversion to cold are kept carefully separated. Aversion to cold stands for exogenous cold, while fear of cold refers to endogenous cold with the differentiation of whether warming or close to heat can release coldness, which undoubtedly plays a certain role in clinical diagnosis. However, the author believes this may lead to negligence to the mechanism of cold symptoms, especially for new learners and result in misdiagnosis of some miscellaneous diseases. Therefore, the author put forward that the key to distinguishing fear of cold and aversion to cold is the defensive qi by judging whether it is weak or stagnant.

关 键 词：畏寒 恶寒 病机 卫气 

分 类 号：R241[医药卫生—中医诊断学]