寒湿发热病机与辨治探要  

Pathogenesis,Differentiation and Treatment of Cold-damp Fever

作　　者：刘庚鑫 张星[2] 张格第 皮持衡[3] 晏子友[3] LIU Gengxin;ZHANG Xing;ZHANG Gedi;PI Chiheng;YAN Ziyou(Jiangxi University of Traditional Chinese Medicine,Nanchang,330004;Shandong University of Traditional Chinese Medicine;Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine)

机构地区：[1]江西中医药大学,江西省南昌市330004 [2]山东中医药大学 [3]江西中医药大学附属医院

出　　处：《中医杂志》2022年第23期2207-2212,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81960843)。

摘　　要：发热是外感或内伤寒湿的临床常见症状之一。通过阐述古人对寒湿发热的认识,从病机、辨证、治法三个方面分析寒湿发热的辨治,认为寒湿发热以寒湿郁表、正邪相争,闭阻气机、蕴热于里,寒湿伤阳、虚阳外浮为基本病机,并比较其与寒湿化热证、阴病见阳证的异同。提出寒湿发热辨证当以三焦辨证为主,结合对发热虚实与热型的诊断,以辛温燥湿法、通阳利湿法、温阳散寒除湿法作为寒湿发热的主要治法,并应慎用清热之品,以期对发热的证型研究与寒湿发热的临床治疗提供一定指导。Fever is a common manifestation of external or internal cold-damp.In this article,we have discussed the ancient understanding of cold-damp fever and explored the theory of identifying and treating cold-damp fever from three aspects including pathogenesis,differentiation and treatment.We believe that the basic pathogenesis of cold-damp fever is cold-damp constraining the exterior,struggle between healthy qi and pathogenic qi,the blocking of qi movement,the embedding of heat in the interior,cold-damp damaging yang,and the floating of deficient yang,which should be differentiated from that of cold-damp transforming into heat pattern,and yin disease but yang syndrome pattern.Sanjiao(三焦)pattern differentiation,together with the distinguishing of fever deficiency and excess and the fever type,is advised in the diagnosis of cold-damp fever.The main treatment methods are drying dampness with acrid-warm medicinals,unblocking yang and draining dampness,warming yang,dissipating cold and eliminating dampness,and the heat-clearing medicinals should be avoided,all of which can provide certain guidance for future syndrome study and clinical treatment of cold-damp fever.

关 键 词：寒湿 发热 三焦辨证 

分 类 号：R255[医药卫生—中医内科学]