徐经世从伏邪论治发热经验  

XU Jingshi's Experience in Treating Fever from the Perspective of Latent Pathogen

作　　者：石小雨 储全根[1,2] 黄辉 郭锦晨[1] 徐经世(指导) SHI Xiaoyu;CHU Quangen;HUANG Hui;GUO Jinchen(School of Traditional Chinese Medicine,Anhui University of Chinese Medicine,Hefei,230038;Institute of Xin'an Medicine and Modernization of Traditional Chinese Medicine,Institute of Health and Medicine,Hefei Comprehensive National Science Centre)

机构地区：[1]安徽中医药大学中医学院,安徽省合肥市230038 [2]合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所

出　　处：《中医杂志》2024年第24期2539-2543,共5页Journal of Traditional Chinese Medicine

基　　金：新安医学与中医药现代化研究所“揭榜挂帅”项目(2023CXMMTCM001);安徽省高校优秀科研创新团队项目(2022AH010037);安徽省中医药传承创新科研项目(2022CCWT03)。

摘　　要：总结徐经世教授从伏邪角度论治发热的临证经验。认为伏邪蕴热是发热的重要病机,针对邪伏少阳及膜原,方选小柴胡汤配伍青蒿以透达膜原、调和少阳;针对伏邪耗伤阴液,治宜清热透邪、顾护阴液,常在柴胡、黄芩、青蒿三药基础上辨证合用白虎汤或竹叶石膏汤或青蒿鳖甲散或生脉饮或四阴煎;针对伏邪引动肝风或逆传心包,则急用凉开之法,方选安宫牛黄丸加减以醒脑开窍、清热解毒、芳香开郁、透邪外达;针对肿瘤放疗、化疗或外科手术后出现的发热,常用自拟经验方扶正安中汤合小柴胡汤、青蒿鳖甲汤加减,以扶正祛邪、顾护中焦。To summarize XU Jingshi's clinical experience in treating fever from the perspective of latent pathogen.It is believed that latent pathogen heat accumulation is an important pathogenesis of fever.For latent pathogen in shaoyang and membrane-source,modified Xiaochaihu Decoction(小柴胡汤)plus Qinghao(Artemisiae Annuae Herba)could be used to expel pathogen through membrane and regulate shaoyang;for latent pathogen leading to yin fluids consumption,treatment should clear heat and expel pathogen,and prescribed with Chaihu(Bupleuri Radix),Huangqin(Scutellaria baicalensis Georgi),Qinghao(Artemisia carvifolia)combined with Baihu Decoction(白虎汤)or Zhuye Shigao Decoction(竹叶石膏汤)or Qinghao Biejia Powder(青蒿鳖甲散)or Shengmai Decoction(生脉饮)or Siyin Decoction(四阴煎)by syndrome differentiation;for latent pathogen leading to liver wind or reverse transmission to the pericardium,treatment should cool to open pathways,and prescribed with modified Angong Niuhuang Pill(安宫牛黄丸)to clear mind and open the orifices,clear heat and resolve toxins,resolve constraint with aromatics,and expel pathogens to outside;for fever after radiotherapy,chemotherapy or surgery for tumours,prescribed with selfprescribed Fuzheng Anzhong Decoction(扶正安中汤)plus Xiaochaihu Decoction(小柴胡汤)and modified Qinghao Biejia Decoction(青蒿鳖甲汤)to reinforce healthy qi and dispel pathogen,and support the middle jiao.

关 键 词：发热 伏邪 名医经验 徐经世 

分 类 号：R249[医药卫生—中医临床基础] R255.1[医药卫生—中医学]