“无寒热”在张仲景诊疗中的应用探讨  

Discussion on the application of‘without aversion to cold or fever’in ZHANG Zhongjing's diagnosis and treatment

作　　者：张乐怡 徐爽 钟相根 ZHANG Yueyi;XU Shuang;ZHONG Xianggen(School of Traditional Chinese Medicine,Bejing University of Chinese Medicine,Beijing 00029,China;State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs,Beijing 100700,China)

机构地区：[1]北京中医药大学中医学院,北京100029 [2]道地药材品质保障与资源持续利用全国重点实验室,北京100700

出　　处：《中华中医药杂志》2023年第11期5259-5262,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划(No.2019YFC1709200,No.2019YFC1709201);北京中医药大学教育科学研究专项课题(No.XJZX2019);北京中医药大学2021年度中医经典理论挖掘与传承专项(No.2021-JYB-ZYWJCC016);北京中医药大学中医学院2021年度医史文献专项(No.2021-yswxzx-05);中央本级重大增减支项目“名贵中药资源可持续利用能力建设项目”(No.2060302-2301-16);2022年第五批全国中医临床优秀人才研修项目(No.国中医药人教函[2022]239号);北京中医药大学教育科学研究课题项目(No.XJZX2019)。

摘　　要：“无寒热”即没有恶寒发热,是以否定句式特意指出患者之正常表现,是对张仲景临床诊疗有重要价值的病例资料。后世医家对其临床诊疗意义没有给予应有的重视。“无寒热”在《伤寒杂病论》共8处,梳理及分析“无寒热”在张仲景诊疗中的应用主要有四:判断痈脓病程,决定诊疗方式;鉴别失血所致寒热,告诫血证禁用汗法;明确疾病性质,鉴别表证特征;提示疾病成因,排除表病机转。文章通过重新解读并挖掘“无寒热”类症状在张仲景临床诊疗决策中的应用及其价值,加深了对张仲景临床诊疗经验的理解,以供临床应用参考。"Without aversion to cold or fever'is an important case data for ZHANG Zhongjing's clinical diagnosis and treatment,which specifically points out the normal performance of the patient in a negative sentence pattern.Later physicians have not paid due attention to its clinical significance.There are 8 places of without aversion to cold or fever'founded in Treatise on Cold Pathogenic and Miscellaneous Diseases.By Sorting and analysing,we've conclude the following four main applications of‘without aversion to cold or fever’in ZHANG Zhongjing diagnosis and treatment:judging the course of abscess and pus disease and deciding its diagnosis and treatment mode;Identify cold-heat caused by blood loss and warn the use of diaphoretic therapy in blood syndrome;Clarify the nature of the disease,identify the characteristics of superficies syndrome;Suggest the cause of disease,exclude the transform of Biao bing.In this paper,we reinterprets and excavates the application and value of‘without aversion to cold or fever'symptoms in ZHANG Zhongjing's clinical diagnosis and treatment,thus deepening the understanding of itforreference in clinical application.

关 键 词：无寒热 《伤寒论》 《金匮要略》 诊疗应用 张仲景原意 

分 类 号：R242[医药卫生—中医临床基础]