遗邪内伏理论初探  

A Preliminary Study on the Theory of Lingering Pathogen Hidden Internally

作　　者：宋淑丽 周延峰[2] 郑伟[2] 崔思远[2] 张莹[1] 王敬毅[2] SONG Shuli;ZHOU Yanfeng;ZHENG Wei;CUI Siyuan;ZHANG Ying;WANG Jingyi

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院血液病科,山东济南250014

出　　处：《新中医》2023年第5期202-206,共5页New Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(82104609)。

摘　　要：《伏邪新书》首次提出“遗邪内伏”,将其归于伏邪之一,并解释为消除临床症状,但未能除尽病根,致遗邪伏于体内,伺机发作。其内伏的“遗邪”外感内伤皆可,而关于邪气的潜伏部位各家则观点各异,遗邪可致疾病复发,所致疾病缠绵难愈,而在复发之前病情常轻微难识,故临床常见患者无明显不适,但亦应详询病史,全面搜集四诊资料,见微知著,把握病机于出现病症之前。而在现代医学角度也可从微小残留灶、肿瘤细胞龛、循环肿瘤细胞及感染性疾病的遗留病毒等导致疾病复发的临床机制来认识遗邪内伏理论。综合分析临床上针对遗邪之治法,在辨证论治基础上,当扶正与祛邪并行,扶正在于调补脏腑,祛邪强调给邪以出路,因势利导;从患者自身方面,应循《黄帝内经》养生之道,食饮有节,起居有常,不妄作劳,外避邪气,内养精神。Fuxie Xinshu(New Treatise on Hidden Pathogens) put forward for the first time that "lingering pathogen hidden internally",which was attributed to one of the hidden pathogen,and was explained as eliminating the clinical symptoms, but failed to eliminate the root cause of the disease, causing the remnant pathogen to lurk in the body and wait for an opportunity to attack. The internal remnant pathogen can cause external and internal injuries, while different schools have different views on the potential location of pathogenic qi. The legacy of pathogenic qi can cause disease recurrence,disease lingering and difficult to heal. Before recurrence,the disease is often mild and difficult to recognize,so common clinical patients have no obvious discomfort,but they should also consult the medical history,comprehensively collect the four diagnostic data,and grasp the pathogenesis before the occurrence of the disease. From the perspective of modern medicine,we can also understand the theory of endogenous pathogens from the clinical mechanism of disease recurrence, such as small residual focus, tumor cell niche, circulating tumor cells,and infectious diseases virus. Comprehensive analysis of clinical treatment methods for the hidden pathogen, on the basis of syndrome differentiation and treatment, when strengthening the righteousness and eliminating pathogenic factors are parallel, strengthening the righteousness lies in regulating and replenishing the zang fu organs,and eliminating pathogenic factors emphasizes giving the pathogen a way out and guiding it according to the situation. From the aspect of patients themselves,they should follow the Huangdi Neijing(The Yellow Emperors’ s Internal Classic) to nourish their health. They should eat and drink properly, live a regular life, do not overwork, avoid pathogenic qi externally, and nourish their spirit inside.

关 键 词：遗邪 遗邪内伏 伏邪 复发 循环肿瘤细胞 肿瘤干细胞 

分 类 号：R254[医药卫生—中医内科学]