从“浊邪害清”论“湿热致中”  

Analysis of stroke with damp-heat pattern on basis of the theory “turbid evil invading the clear orifice”

作　　者：温雅[1] 许永楷[2] 孙美灵 郭永胜 张思超[1] Wen Ya;Xu Yongkai;Sun Meiling;Guo Yongsheng;Zhang Sichao(Shandong University of Traditional Chinese Medicine,Shandong 250355,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong 250014,China;Guizhou University of Chinese Medicine,Guizhou 550025,China)

机构地区：[1]山东中医药大学,山东250355 [2]山东中医药大学附属医院 [3]贵州中医药大学

出　　处：《北京中医药大学学报》2021年第11期987-991,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81173183);全国中医学术流派传承工作室第二轮建设项目(No.[2019]62);山东省中医药科技发展计划项目(No.2019-0016);山东中医药大学123人才工程项目(No.[2016]71)。

摘　　要：因今人嗜食肥甘厚味、饱啖辛辣过度,中风湿热证的发病率不断升高。本文通过梳理"浊邪""清窍""浊邪害清"理论内涵与源流,明确湿热是中风发生发展不可忽视的重要病因。湿热病因有外感、内伤之别,湿热合邪,困碍中焦,阻滞气机,上蒙清窍,清窍壅塞,导致头面诸症,甚则诱发中风的发生。叶天士"浊邪害清"理论可视为"湿热致中"的概括性论述,中风湿热证的诊断、治疗和预防应当引起临床重视。基于"脑肠相通"假说,提出中风湿热证病变核心责之"脑-脾胃-肠",预防"湿热致中",应树立脾胃、大肠脏腑发病观,治疗上应以祛湿清热、通腑开窍为核心大法。"浊邪害清"理论与祛湿清热、通腑开窍法均源于温病学理论与经验,"分消走泄""滋阴生津"等治法在中风治疗中亦多有应用,因此温病学理论与经验或可为中风的防治提供新的思路与方法。Because people nowadays are addicted to eating too much fat, sweet food with thick taste, the incidence of stroke with damp-heat pattern is constantly increasing. Through combing the theoretical connotation and origins of “turbidity”, “clear orifice”, and “turbid evil invading the clear orifice”, this article clarifies that damp heat is an important cause that cannot be ignored in the occurrence and development of stroke. The causes of damp-heat include external contraction and internal injury. Damp-heat obstructs the qi movement in the middle jiao, and blocks clear orifice in the upper part of the body, leading to the symptoms of the head and face, and even inducing the occurrence of stroke. Ye Tianshi’s theory of “turbid evil invading the clear orifice” can be regarded as a general exposition of “damp-heat leading to stroke”, so the diagnosis, treatment and prevention of damp-heat pattern should be emphasized. Based on the hypothesis of “brain-intestine interlinkage”, the core organs affected for the disease of stroke with damp-heat pattern are the brain, spleen, stomach and intestine. To prevent stroke due to damp-heat, the above-mentioned organs should be addressed by clearing dampness and heat, unblocking the fu organs and clearing orifices. The theory of “turbid evil invading the clear orifice” and the above-mentioned therapeutic methods are all derived from the theory and treatment experience of febrile disease. Besides, therapies such as “differentiating and dispelling pathogenic factors from the three jiao” and “nourishing yin and promoting generation of body fluids” are also used in the treatment of stroke. Therefore, the theory and experience of febrile disease may provide new ideas and methods for the prevention and treatment of stroke.

关 键 词：浊邪 清窍 “浊邪害清”理论 湿热致中 中风 湿热 

分 类 号：R228[医药卫生—中医基础理论]