钱乙“因时分治”小儿热性惊厥思想荟萃  

Qian Yi’s ideas gathering of“treatment in accordance with the times”in pediatric febrile convulsion

作　　者：余欢 蔡萌 李鑫[4] 张涤 帅云飞 YU Huan;CAI Meng;LI Xin;ZHANG Di;SHUAI Yunfei(The First Clinical College,Hunan University of Chinese Medicinethe First Hospital of Hunan University of Chinese Medicine,Hunan Province,Changsha410007,China;Domestic First-Class Discipline Construction Project of Chinese Medicine,Hunan University of Chinese Medicine,Hunan Province,Changsha410007,China;Pediatric Center,Zhujiang Hospital,Southern Medical University,Guangdong Province,Guangzhou510280,China;Hunan Key Laboratory of Diagnosis of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Hunan Province,Changsha410208,China)

机构地区：[1]湖南中医药大学第一中医临床学院湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学中医学国内一流建设学科,湖南长沙410007 [3]南方医科大学珠江医院儿科中心,广东广州510280 [4]湖南中医药大学中医诊断学湖南省重点实验室,湖南长沙410208

出　　处：《中国医药导报》2024年第28期164-168,共5页China Medical Herald

基　　金：湖南省自然科学基金项目(2020JJ4478);湖南省教育厅科学研究项目(19B425);湖南中医药大学中医儿科学湖南省“双一流”学科建设项目(4912-0005001010)。

摘　　要：热性惊厥为小儿临床常见危急重症,以高热、抽搐和昏迷为主症。结合《小儿药证直诀》中(早晨发搐、日午发搐、日晚发搐、夜间发搐)四节,以“时辰节律”为主线,加钱乙“五脏辨治”思想,融贯时辰与五脏盛衰,总结抽搐病因。早晨多因肝阳化风、水不涵木、风动成搐,中午多因心火燔灼、扰肝动风、风火引搐,傍晚多因肺脾本虚、木火刑金、热极生风,夜间多因肾虚脾弱、土不伏火、心肾不交。梳理该病病因、病机和证候,随时辰阴阳消长变化论治小儿惊风,灵活运用钱乙名方(地黄丸、泻青丸、导赤散、凉惊丸和益黄散等),因时调理情绪、重视服药时机、将方药与外治法结合,为该病诊治提供新思路。Febrile convulsion is a common and critical condition in pediatric clinical practice,characterized by high fever,convulsions and coma.Combined with the four sections of Xiao’er Yao Zheng Zhi Jue(morning convulsions,noon convulsions,evening convulsions,and night convulsions),with“rhythm of the hour”as main line,and Qian Yi’s idea of“syndrome differentiation of five internal organs”,the time and the rise and fall of the five viscera are integrated.Summarize the causes of convulsions:in the morning,it is often due to liver yang transforming into wind,water not obstructing wood,and the wind moves into convulsions,at noon,it is mostly due to heart fire,disturbance of liver and wind,wind and fire convulsions,in the evening,it is often due to lung and spleen deficiency,wood fire punishment,and extreme heat that generates wind,at night,it is mostly due to kidney deficiency and spleen weakness,soil does not ambush fire,and heart and kidney do not communicate.Sort out the etiology,pathogenesis and symptoms of the disease,and treat infantile convulsion according to the changes in yin and yang over time,flexibly use famous prescription of Qian Yi(Dihuang Wan,Xieqing Wan,Daochi San,Liangjing Wan,Yihuang San,etc.).Adjusting emotions according to the time,emphasizing the timing of medication,and combining traditional Chinese medicine with external treatment methods provide new ideas for the diagnosis and treatment of this disease.

关 键 词：热性惊厥 钱乙 因时分治 五脏辨证 

分 类 号：R272.3[医药卫生—中医儿科学]