唐宋“四时五脏阴阳毒”瘟疫诊疗体系  

The Diagnosis and Treatment System of Plague with "Four Seasons and Five Zang-organs Yin-Yang Poison" in Tang and Song Dynasties

作　　者：耿浩然 姚洁敏[1] GENG Haoran;YAO Jieming(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学,上海201203

出　　处：《中医药导报》2024年第12期119-123,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家社会科学基金重大项目(21&ZD349);教育部人文社科研究项目(19YJCZH223)。

摘　　要：《备急千金要方》在《金匮要略》《诸病源候论》阐述认识“阴阳毒”的基础上,创造性地提出了“四时五脏阴阳毒”时气瘟疫诊疗体系,分为青筋牵病、赤脉扌費病、黄肉随病、白气狸病、黑骨温病5种类别,各有腑虚、脏实之分,其治疗大法以泄热发表为主,兼顾护阴,“腑虚”偏逐表邪,“脏实”偏逐里热,各有方药以治之。至宋代庞安时进一步将此体系完善发扬光大。此体系结构严谨、处方精妙、特色鲜明,充分凸显了中医学的“时-空”思维特色,上承两汉之学,下启明清温病之理念,既是中医学术发展史上的重要环节,也对当今瘟疫证治有所启发。On the basis of the understanding of "Yin and Yang toxicity" in Jin Kui Yao Lue and Zhubing Yuanhou Lun,the book Beiji Qianjin Yaofang creatively proposed a diagnosis and treatment system for epidemic diseases caused by "Yin and Yang toxicity in the four seasons and five organs".It was divided into five categories:green tendon disease,red vein disease,yellow flesh disease,white Qi civet disease,and black bone temperature disease,each with the distinction of organ deficiency and organ excess disease.Its treatment method mainly focused on relieving heat,while also taking into account the protection of Yin."Organ deficiency" tends to eliminate external pathogens,while "Organ excess" tends to eliminate internal heat,and each had its own prescription and medicine for treatment.In the Song Dynasty,PANG Anshi further improved and developed this system.This system has a rigorous structure,exquisite prescriptions,and distinctive features,fully highlighting the "time-space" thinking characteristics of traditional Chinese medicine.It inherited the knowledge of the Han Dynasty and inspires the concept of warm diseases in the Ming and Qing Dynasties.It was not only an important link in the development history of traditional Chinese medicine,but also provided inspiration for the diagnosis and treatment of epidemics today.

关 键 词：时气瘟疫 四时五脏阴阳毒 唐宋 《备急千金要方》 医史文献 

分 类 号：R2-09[医药卫生—中医学]