论《广瘟疫论》透疫四法对吴又可透疫理念的继承与发挥  

Discussion on the Inheritance and Development of Wu Youke′s Epidemic Treatment Philosophy by the “Four Methods of Penetration” in the Expanded Treatise on Pestilential Fevers

作　　者：李富震[1] 苏金峰[1] 姜德友[1] Li Fuzhen;Su Jinfeng(Jiang Deyou.Heilongjiang University of Chinese Medicine,Heilongjiang,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中国中医急症》2025年第1期141-144,158,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：全国中医药研究生教育研究课题(YJS-YB-2023-18);黑龙江省教育科学规划重点课题(GJB1424166);黑龙江省中医药经典普及化专项课题项目(ZYW2024-061)。

摘　　要：吴又可善用透法治疗疫病,对后世影响深远。清代名医戴天章在吴氏学说基础上撰成《广瘟疫论》,书中对通腑透邪、逐瘀泄热、开达膜原、滋养透邪透疫四法论述尤为深入,具有重要指导意义。本文深入剖析戴天章《广瘟疫论》透疫四法,主要包括开达膜原明辨表里,注重“孤邪”;通腑透邪力辟寒温,“三分”指征,细化治方;逐瘀泄热倡用“蓄血三焦辨证”;论广滋养透邪,增述“五变”,从中探寻其对吴又可透疫理念的继承与发挥,如疫邪在半表半里之时达原饮和柴胡剂之运用区分、开达膜原之“孤邪”加味法、通腑透邪六大用药手法、“厥阴蓄血”证治等,以期对现代临床提供助力。Wu Youke is good at using penetration method to treat epidemic diseases,which has far-reaching influence on later generations. Later,Dai Tianzhang,a famous doctor in the Qing Dynasty,wrote Expanded Treatise on Pestilential Fevers on the basis of Wu′s theory. The book is particularly in-depth on the four methods of penetrating the epidemic,such as dredging fu organs and penetrating evil,expelling stasis and releasing heat,opening up the membrane,nourishing and penetrating evil,which has important guiding significance. This paper attempts to deeply analyze the above-mentioned four methods of Dai Tianzhang′s Expanded Treatise on Pestilential Fevers,including opening the pericardium to distinguish between exterior and interior,emphasizing“isolated pathogens”;penetrating fu to expel pathogens,addressing cold and heat,and refining treatment plans with“three divisions”indicators;promoting blood circulation to clear heat,advocating the“blood stagnation in the Sanjiao”differentiation;discussing extensive nourishment and penetration,adding the“five transformations”. The paper further explores how Dai Tianzhang inherited and developed Wu Youke′s ideas on penetration therapy,such as distinguishing between the use of Dayuan Decoction and Chaihu Decoction when the pathogen is in the semi-exterior and semi-interior stage,adding herbs for“isolated pathogens”when opening the pericardium,employing six specific medication techniques for penetrating fu to expel pathogens,and treating the“Jueyin Blood Stagnation”syndrome. It is hoped that this study will provide valuable insights for modern clinical practice.

关 键 词：疫病 《广瘟疫论》 戴天章 吴又可 透法 

分 类 号：R249.8[医药卫生—中医临床基础]