泄湿透热法治疗湿遏热伏证的证治研究  

Syndrome differentiation and treatment research on eliminating dampness and dispelling heat method in the syndrome of dampness obstructing heat and suppressing heat

作　　者：贾志新 梁葆朱 李东明 赵乐 JIA Zhixin;LIANG Baozhu;LI Dongming;ZHAO Le(Shanxi University of Chinese Medicine,Jinzhong 030619,China)

机构地区：[1]山西中医药大学,晋中030619

出　　处：《北京中医药大学学报》2023年第10期1357-1360,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：山西省高等学校教学改革创新项目(No.J20220780);山西中医药大学科技创新能力培育计划“基础研究专项”项目[No.2020PY-JC(Y)-10];山西中医药大学博士科研启动基金(No.2023BK49)。

摘　　要：通过对《温热论》原文“湿遏热伏”相关内容的学习,发现文献中多以香燥、咸寒、苦寒等药物进行治疗,与原文所言“泄湿透热”“防其就干”的本意不符。本文从湿遏热伏的临床表现,以及“泄”“泄湿”“泄湿透热”的释义出发,结合各家观点,对湿遏热伏的证治内容进行分析。湿遏热伏证的临床表现除白苔绛底外,还可出现恶寒、发热、脘闷、神昏、舌干、苔厚黄、苔腻、脉滑等卫、气、营分的证候表现;其病位广泛,以肺、脾、胃为多;治以辛苦甘淡之品泄湿透热,其中辛苦开泄湿热是目的,甘淡渗利是治疗手段之一,临证宜慎用香燥、咸寒、苦寒之品,避免误解误用。Through the study of the relevant content of"dampness obstructing heat and suppressing heat"in the original text of Wenre Lun,it was found that the literature mostly use fragrant and dry,salty and cold,or bitter and cold medicinals for treatment,which is inconsistent with the original ideas of"eliminating dampness and dispelling heat"and"preventing its dryness".Therefore,beginning from the clinical manifestations of dampness obstructing heat and suppressing heat,and the definitions of"eliminating","eliminating dampness",and"eliminating dampness and dispelling heat",combined with various perspectives,the syndrome differentiation and treatment content of dampness obstructing heat and suppressing heat was analyzed.The clinical manifestations of the syndrome of dampness obstructing heat and suppressing heat,in addition to a deep red tongue with white fur,may also include symptoms such as aversion to cold,fever,epigastric fullness,unconsciousness,dry tongue,thick yellow fur,greasy fur,and slippery pulse,which represent disorders of weifen,qifen,and yingfen.The disease location is wide-ranging,mainly involving the lung,spleen,and stomach.The treatment strategy is to eliminate dampness and dispel the heat with medicinals acrid,bitter,sweet and bland in flavour.The goal is to open up the dampness and heat with acrid and bitter medicinals,and percolating and draining dampness with sweet and bland medicinals is only one of the available treatment methods.In clinical practice,caution should be exercised when using fragrant and dry,salty and cold,or bitter and cold medicinals to avoid misunderstandings and misuse.

关 键 词：泄湿透热 湿遏热伏 证治研究 辛开苦降 

分 类 号：R228[医药卫生—中医基础理论]