陈乔林论外感热病与汗泄法  

Chen Qiaolin elaborates on exogenous fever and the method of sweating and discharging

作　　者：李云华 王志祥[2] 罗庆文[2] 曹悦 包翠玲 陈乔林(指导)[2] Li Yunhua;Wang Zhixiang;Luo Qingwen;Cao Yue;Bao Cuiling;Chen Qiaolin

机构地区：[1]云南中医药大学,云南昆明650500 [2]云南省中医医院,云南昆明650021

出　　处：《中医临床研究》2020年第12期11-13,共3页Clinical Journal Of Chinese Medicine

摘　　要：《素问·热论》提出:“今夫热病者,皆伤寒之类也”,所说的并不是“皆伤寒病也”而是“皆伤寒之类也”陈乔林认为外感热病所感受的外邪是多样性的,非独指“寒”邪,《热论》是把多样性的急性外感热病,归属于伤寒一类,而非独指单一的伤寒。外感热病具有感受外邪,毒力强暴,受邪后,邪正互动,发病急骤,传变迅速,病情严重,后果转归不良等特点。外感热病的病机实指阳郁为病。外感邪气,皮肤收引,腠理密闭,气行不畅,郁而生热。此时,正邪对峙,正气欲拒邪外出而未能,相争于表为表郁,相争于里为里郁,表里俱相争为表里皆郁,阳气怫郁、阻遏,乃至壅塞,化火毒而败经脉、脏腑。汗、泄法是外感热病的治疗大法,“汗”不是单纯的“发汗”,实质是“透邪外达”,“泄”不是单纯的“泄下”,实质是“泄越其热”“汗”“泄”的主要目的是顺正祛邪,扫除障碍,宣通壅遏,激浊扬清,破郁为通,以解决外感热病“阳郁”的核心病机。“汗”“泄”追求的是依据邪正互动态势宣散透解邪毒,因势利导,因机立胜,并不以单纯的追杀邪毒为目的,简介陈乔林治疗外感热病常用经验方“加味葛根芩连汤”以明其理。The"Heat Theory"in Huangdi Neijing proposes that"Nowadays,the fevers are exogenous febrile diseases and so on."and what is said is not"exogenous febrile diseases"but"exogenous febrile diseases and so on".Chen Qiaolin thinks there are many causes of fever in addition to cold.Exogenous febrile disease has the characteristics of feeling exogenous pathogenic factors,interaction between pathogenic factors and positive factors,rapid onset,rapid transmission,severe disease condition,and poor outcome after being infected.The pathogenesis of exogenous fever refers to that Yang Qi cannot run smoothly and gather together.After feeling exogenous pathogens,the skin and muscles are tightened,the Yang Qi is not running smoothly,and the heat is caused by the accumulation.At this time,the confrontation between the positive and the exogenous pathogenic factors,the desire of the positive Qi to refuse exogenous pathogenic factors to go out fails.The struggle between positive Qi and exogenous pathogenic factors can occur on the surface or/and inside.The method of sweating and discharging is the treatment method for exogenous febrile diseases.The essence of"sweating"is not simply"sweating"but"permeating pathogenic factors and reaching the outside".The essence of"discharging"is"discharging excess heat".The main purposes of"weating"and"discharging"are to eliminate pathogenic factors,clear up turbidity,and clear up stasis,so as to solve the core pathogenesis of exogenous febrile diseases.Here is a brief introduction to Chen Qiaolin's experience in the treatment of exogenous fever,"Modified Gegen Qilian Decoction"(加味葛根芩连汤)to explain its rationale.

关 键 词：外感热病 汗泄法 加味葛根芩连汤 

分 类 号：R249[医药卫生—中医临床基础]