从中医古籍文献探讨湿热病的诊疗思路  

Discussion on the Diagnosis and Treatment of Dampness-heat Disease from Traditional Chinese Medicine Ancient Documents

作　　者：张冉冉 郭晓霞[2] ZHANG Ranran;GUO Xiaoxia(Shanxi Institute of Traditional Chinese Medicine,Shanxi Province,Taiyuan 030012,China;Department of Metabolism,Shanxi Academy of Traditional Chinese Medicine,Shanxi Province,Taiyuan 030012,China)

机构地区：[1]山西省中医药研究院,山西太原030012 [2]山西省中医院代谢病科,山西太原030012

出　　处：《中国中医药现代远程教育》2024年第21期50-53,共4页Chinese Medicine Modern Distance Education of China

基　　金：国家中医药管理局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〕1号】;山西省中医药管理局科研课题【No.2023ZYYA006,2022ZYYZ005】。

摘　　要：古代文献中,湿热病的临床症状具有多样性,其治疗可见于多种疾病当中。临床发现,综合运用六经辨证与三焦辨证等论治湿热病,具有重要指导意义。文章根据湿热病的临床表现,结合《伤寒论》中湿热病证和《温病条辨》中“湿温”“暑温”“伏暑”等内容,探讨湿热病的病因病机和辨证施治思路。文章认为素体脾胃虚弱、外感湿热病邪是湿热病的主要病因,病机为内外合邪、标本同病,治疗时应以清热利湿为主,重点在“给邪以出路”。因此在湿热病的诊疗中,根据临床表现,需明辨病邪来源、病变部位以及疾病传变,从而确定治法方药。The clinical symptoms of dampness-heat disease are diverse,and its treatment can be seen in various diseases in ancient documents.It is found that the comprehensive application of syndrome differentiation of six meridians and Sanjiao in the treatment of dampness-heat disease has important guiding significance.According to the clinical manifestations of dampness-heat disease,com⁃bined with the syndrome of dampness-heat disease in Shanghan Lun and the contents of“damp warm”,“warm disease in summer”and“latent summer-heat disease”in Wenbing Tiaobian.The main cause of dampness-heat disease is the weakness of the spleen and stomach and exogenous dampness-heat pathogenic factors.The pathogenesis is the combination of internal and external pathogenic factors and the same pathogenic factors of specimens.The treatment should focus on clearing heat and dispelling dampness-with the focus on“giving pathogen a way out”.Therefore,in the diagnosis and treatment of dampness-heat disease,according to the clinical manifestations,it is necessary to distinguish the source of pathogenic factors,the lesion site and the disease transmission,so as to de⁃termine the treatment.

关 键 词：湿热病 《伤寒论》 《温病条辨》 六经辨证 三焦辨证 临床诊疗思路 

分 类 号：R255[医药卫生—中医内科学]