从“五辨”探讨“热蒸肉腐”的内涵及临床意义  

Discussion on the connotation and clinical value of hot steaming causes carrion'based on the‘five differentiation'

作　　者：夏庭伟 杨越 李炜弘[1] 丁维俊[1] 汤朝晖[1] 成词松[1] 雍小嘉[1] 叶俏波[1] 田茸[1] 赖寒 冯全生[1] 李灿东[3] XIA Tingwei;YANG Yue;LI Weihong;DING Weijun;TANG Zhaohui;CHENG Cisong;YONG Xiaojia;YE Qiaobo;TIAN Rong;LAI Han;FENG Quansheng;LI Candong(School of Basic Medical Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Sichuan Province Orthopedic Hospital,Chengdu 610041,China;Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China)

机构地区：[1]成都中医药大学基础医学院,成都610075 [2]四川省骨科医院,成都610041 [3]福建中医药大学,福州350122

出　　处：《中华中医药杂志》2024年第9期4549-4552,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中国博士后科学基金面上项目(No.2021M693790);成都中医药大学“杏林学者”学科人才科研提升计划(No.BSH2020013);成都中医药大学基础医学院教育教学改革项目;四川省高校人文社会科学重点研究基地——四川中医药文化协同发展研究中心立项课题(No.2021XT31,No.2023XT106)。

摘　　要：“热蒸肉腐”是痈核心病机之一。历代医家常将其解释为热毒伤血,存在片面性。“五辨”思维(辨人、辨症、辨病、辨证、辨机)是把握整体性、动态性、个体化特征的当代中医诊断新路径。文章基于“五辨”思维,提出辨人明确痈的易感性因素,以助健康管理;辨症把握痈发病、加重的外在条件,明确“热”之源、“热”之性,客观化呈现痈“热”的阶段、程度;辨病以察“热蒸肉腐”所致中西疾病范围,助于锁定病理阶段;辨证以识“热蒸肉腐”病位、病性,证的兼杂主次,动态演变等阶段性特征,准确制定治则治法;辨机以探“热蒸肉腐”内在机制,预判传变趋势,提前干预。以系统科学为指引,探讨“热蒸肉腐”病机内涵,以期对痈临床诊治有所裨益。‘Hot steaming causes carrion'is one of the core pathogenesis of carbuncle.Physicians of the past dynasties often interpreted it as heat and poison hurting blood,which is inevitably one-sided."Five differentiation'thinking(individual differentiation,symptom differentiation,disease differentiation,syndrome differentiation and pathogenesis differentiation)is a new way of modern Chinese medicine diagnosis with integrated,dynamic and individualized characteristics.Based on the thinking of‘five differentiation',this paper proposes individual differentiation is to identify the susceptible factors of carbuncle for health management;symptom differentiation is to identify the external conditions of carbuncle onset and aggravation,clarify the source and nature of heat',and objectively present the pathological change of carbuncle;disease differentiation can observe the range of Chinese and western diseases caused by hot steaming causes carrion'to clarity the pathological stage;syndrome differentiation is to identify the disease-location and disease-character,the primary and secondary symptoms,dynamic evolution and other phased characteristics of‘hot steaming causes carrion',and accurately formulate the treatment principles and methods;Pathogenesis differentiation is to identify the internal mechanism of hot steaming causes carrion',predict the trend of transmission and change,and intervene in advance.Under the guidance of system science,this paper discusses the pathogenesis of‘hot steaming causes carrion'in order to benefit the clinical diagnosis and treatment of carbuncle.

关 键 词：五辨 热蒸肉腐 痈 整体观 动态性 个体化 

分 类 号：R261[医药卫生—中医外科学]