中医对慢性鼻炎的认知及“鼻窒”的定名  

The understanding of chronic rhinitis in traditional Chinese medicine and the definition of nasal obstruction disease

作　　者：高新颜[1] Gao Xinyan(Institute of Chinese Medical History and Literature,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中国医史文献研究所,北京100700

出　　处：《中华医史杂志》2022年第3期157-161,共5页Chinese Journal of Medical History

基　　金：全国科技名词委科研项目(YB2019022);中国中医科学院科技创新工程项目(CI2021A00204)。

摘　　要：梳理中医学对慢性鼻炎的认知与命名的发展脉络,发现以鼻塞为主要特征的病症在《黄帝内经》与《武威医简》中已见记载,但未提出病名。古代医家多数未将慢性鼻炎与急性鼻炎等病严格区分,古籍中的“鼻齆”“鼻塞”“不闻香臭”“鼻窒”“鼻塞不闻”“气息不通”等病证包含相当比例的慢性鼻炎。近代中医曾将“鼻渊”“鼻齆”“鼻塞”等中医病名与西医之慢性鼻炎对应,“鼻渊”使用较广,但因词不达意而遭淘汰。1970年代,多部教材提出将“鼻窒”用作慢性鼻炎的中医病名。1980年第4版全国中医统编教材《中医耳鼻喉科学》首次将“鼻窒”确立为规范病名。“鼻窒”病名虽然在术语定名的单义性、科学性上也存在欠缺,但通过统编教材、标准规范、临床指南等途径的大力推介,仍被中医界普遍接受。“鼻窒”的规范化过程表明,古代文献中不存在慢性鼻炎的等价中医病名。提示中西医病名对照必须进行充分的调研和论证,且即便如此,也经常徒劳无功。在阅读和利用中医古籍时,必须了解术语内涵的古今差异。This paper reports on review of the conceptual cognition and definition of chronic rhinitis in traditional Chinese medicine(TCM).Diseases with nasal congestion as the main symptom were recorded in The Yellow Emperor's Inner Classic(Huang Di Nei Jing)and Medical Bamboo slips of Wu Wei(Wu Wei Yi Jian),but these diseases had not been given names at that point in time.Chronic rhinitis and acute rhinitis had not been distinguished clearly.Some symptoms,in ancient Chinese medical books,indicated some possibility as those of chronic rhinitis,such as"bi weng"(鼻齆),"stuffy nose"(鼻塞),"anosmia"(不闻香臭),"nasal obstruction"(鼻窒),"stuffy nose with anosmia"(鼻塞不闻)and"poor nasal passages"(气息不通).In the first half of the last century,"biyuan"(鼻渊),"biweng"(鼻齆)and"stuffy nose"(鼻塞)were classified at the symptoms of chronic rhinitis with the same names in traditional Chinese medicine."Biyuan"was widely used at that time,but was gradually eliminated for the lack of semantic meaning.In the 1970s,"nasal obstruction"was proposed by many textbooks as the name of TCM for chronic rhinitis.In 1980,"nasal obstruction disease"(鼻窒)was finally specified as the formal name by Otorhinolaryngology of TCM(the 4th edition),the national unified textbook.This term has been widely accepted in the field of traditional Chinese medicine,driven by the united textbooks and clinical guidelines,while it is still insufficient in the perspective of meaning and science.The process of normalisation of"nasal obstruction disease"shows that the name of chronic rhinitis in ancient Chinese medicine is not equivalent to its term in modern medicine.It also suggests that the comparison of disease names between traditional Chinese medicine and western medicine must be fully investigated.It is necessary to understand the differences between ancient and modern connotations of terminology when reading and using ancient Chinese medicine literature.

关 键 词：慢性鼻炎 鼻窒 中医病名 中医术语 

分 类 号：R276.1[医药卫生—中医五官科学]