风寒初感人体常见寒相关症状反应辨析  

Differentiation and analysis of common cold-related symptom responses at initial stage of wind-cold pathogenic factors attack

作　　者：董俭[1] 王天芳 李晓莉[1] 周开林[1] 沈无瑕 李冠颖 王珊珊[1] DONG Jian;WANG Tian-fang;LI Xiao-li;ZHOU Kai-lin;SHEN Wu-xia;LI Guan-ying;WANG Shan-shan(School of Humanities,Beijing University of Chinese Medicine,Beijing 100029,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]北京中医药大学人文学院,北京100029 [2]北京中医药大学中医学院,北京100029 [3]中国康复研究中心,北京100068

出　　处：《中华中医药杂志》2023年第2期750-753,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京中医药大学新教师启动基金项目(No.2019-JYB-XJSJJ016);北京中医药大学教育专项课题(No.XJZX2016)。

摘　　要：人体外感阶段的寒、热症状反应为历代医家所重视。寒相关症状主要包括恶寒、畏寒、恶风、寒战等,风寒初感以恶寒、恶风多见,其在《中医诊断学》的内涵、临床意义界定存在模糊与不一致,在中医诊断和临床教材中的应用也有一定衔接问题。为厘清恶寒、恶风等风寒初感阶段寒相关症状的内涵与临床意义,文章结合古今文献展开探讨,得出恶寒在古代医籍中泛指怕冷,自现代教材与畏寒加以区分,但在临床辨析二者时应参照他症。对恶寒临床意义的认识,也不应局限于其与外感表证的对应关系。而恶风主要病机在于表虚,表现为当风不适感,可与恶寒并见。经以上辨析,以期厘清《中医诊断学》教材中寒相关概念的内涵与外延,为其规范化使用提供参考。The symptom responses related to cold and heat at the initial stage of exterior pathogenic factor attack have been greatly appreciated by doctors of all dynasties. The cold-related symptoms mainly include Wu Han(aversion to cold),Wei Han(fear of cold),Wu Feng(aversion to wind),and Han Zhan(chills),with aversion to cold/wind most commonly seen at the initial stage of wind-cold attack. While some of those cold-related symptoms are vague and inconsistent in terms of connotation and clinical significance in various TCM Diagnostics textbooks,and they are not consistently applied in various TCM clinical textbooks. In order to clarify the connotation and clinical significance of those cold-related symptoms seen at the initial stage of wind-cold attack,an analysis is carried out in this paper by integrating ideas from both ancient and modern books and papers.On basis of that,the following ideas are confirmed: ‘Aversion to cold’ has been used as a symptom generally referring to ‘fear of cold’,and it’s only clearly differentiated from the symptom of ‘intolerance of cold’ until modern TCM Diagnostics textbooks.Other symptoms and factors should be taken into consideration in the clinical differentiation of these two symptoms. Besides,the clinical significance of ‘aversion to cold’ should not be limited to its correlation to exterior patterns. The main pathogenesis of ‘aversion to wind’ should be viewed as exterior deficiency instead of being similar to that of ‘aversion to cold’. Accordingly,the clinical manifestation of ‘aversion to wind’ is the discomfort when exposed to wind,and this symptom could coexist with ‘aversion to cold’. With such a differentiation and analysis,we hope to clarify the connation and significance of cold-related symptoms in TCM Diagnostics and provide references for their standardized usage.

关 键 词：寒邪 风邪 症状反应 恶寒 恶风 畏寒 

分 类 号：R254[医药卫生—中医内科学]