再谈“寒温统一论”  

Talking about the theory of unification in typhoid and warm disease

作　　者：王海铭[1] 康静[1] 潘英英 WANG Haiming

机构地区：[1]山西省人民医院,山西太原030012

出　　处：《中医临床研究》2024年第7期20-23,共4页Clinical Journal Of Chinese Medicine

基　　金：省级名中医传承工作室建设项目(SXSMZYGZS040)。

摘　　要：外感热病中的寒温之争由来已久,一定程度上造成了临床中的困扰。文章从六经辨证、中医体质学、免疫学、外感热病治疗学等角度论证了伤寒与温病的统一性:一是从六经辨证认识,伤寒、温病辨证规律的相同之处;二是从中医体质学认识,伤寒、温病的辨治体系均与体质相关;三是从现代医学免疫学的观点认识,伤寒、温病均属于病原体感染后的免疫反应;四是以新型冠状病毒感染重型为例,从免疫学观点认识“寒温统一论”;五是从《黄帝内经》中“各通其脏脉”治疗外感热病解读“寒温统一论”;六是从《黄帝内经》中“疏其血气”治疗外感热病解读“寒温统一论”;七是从扶正法治疗外感热病解读“寒温统一论”。基于外感热病属于感染诱发的免疫应答过程,文中指出温病病邪从口鼻而入,故病原体更早定植于呼吸道咽、气管、肺等部位;而伤寒中于皮毛,其发病与机体非特异性免疫的皮肤黏膜屏障作用相关,但两者免疫过程及转归大致是相同的。治疗上,二者均应早期疏通气机以祛邪;及早运用清热解毒及活血化瘀药物以扭转截断病情的进展;重视扶正,防止急性虚证的产生。最后结合耗散结构理论对其进行了相应的诠释:在引入熵的概念后,伤寒与温病可以从发病机制和治疗学上都得到相应的统一。由此证实两者在发生发展规律、病因病机认识、辨证体系及治疗方法上都可以融合统一。The unification in typhoid and warm diseases from the perspectives of syndrome differentiation of the six meridians,TCM constitution,immunology,and the treatment of exogenous febrile diseases.①Understanding theT similarities in syndrome differentiation laws of typhoid and warm diseases from the six meridians.②Understanding from the perspective of TCM constitution,the differentiation and treatment system of typhoid and warm diseases is related to constitution.③From the perspective of modern medical immunology,both typhoid and warm diseases belong to the immune response after pathogen infection.④Taking COVID-19 as an example to understand the theory of unification in typhoid and warm diseases from the viewpoint of immunology.⑤Interpreting the theory of unification in typhoid and warm diseases from the perspective of treating exogenous febrile diseases through unblocking its internal meridians in Huangdi Neijing(《黄帝内经》).⑥Interpreting the theory of unification in typhoid and warm diseases from the perspective of the treatment of exogenous febrile diseases through dispersing blood and Qi(气)in Huangdi Neijing.⑦Interpreting the unification in typhoid and warm diseases theory from the treatment of exogenous febrile diseases by the method of strengthening the body.Based on the fact that exogenous febrile diseases belong to the immune response process induced by infection,it is pointed out that the pathogenic factors of febrile diseases enter from the mouth and nose,so the pathogens colonize the respiratory tract such as the pharynx,trachea,and lungs earlier.Typhoid fever,on the other hand,originates from the skin and fur,and its onset is related to the non-specific immune barrier function of the body’s skin and mucosa.However,the immune processes and outcomes of the two are roughly the same.In terms of treatment,both should be unblocked in the early stage to dispel pathogenic factors.Drugs for clearing heat,detoxifying,and promoting blood circulation and resolving blood stasis should be used

关 键 词：寒温统一论 六经辨证 中医体质学 免疫学 耗散结构理论 

分 类 号：R22[医药卫生—中医基础理论]