从治疫古籍出发辨疫病与伤寒、温病关系  

Analysis of Relationship between Epidemic Diseases and Typhoid Fever and Warm Diseases from the Perspective of Ancient Books on Epidemic Treatment

作　　者：赵妍[1] 李海波[1] ZHAO Yan;LI Haibo(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《辽宁中医药大学学报》2025年第3期146-149,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中医药管理局科研基金项目(GZY-KJS-2020-056);辽宁省教育厅高校科研基金项目(LJKMZ20221323)。

摘　　要：疫病学具有一套独特的理论体系,疫病是由杂气引起的一类急性外感病,杂气并非外感六淫,不具有寒、热、温、凉等属性,但又可兼夹风、寒、暑、湿、燥、火等六淫邪气。杂气由口鼻而入,伏于膜原或中焦,传变形式包括表里九传、三焦传变、十二经传变、六经传变等多种形式,其病机本质是郁热内发,治疗以清里热为主。明清时期的疫病学家以清里热为基本治则,发展了汗、下二法,将汗法扩展为求汗之法,通过各种治法达到气机通、汗自出、邪随汗并的目的。下法不拘结粪,提出“时疫下不厌早”“时疫在下其郁热”等说法,从理法方药等方面将疫病与伤寒、温病进行区分,提出疫病不是伤寒,也不属于温病范围。疫病学理论对当今的传染病治疗仍具指导意义,疫病治疗注重逐邪外出,将清热、攻下等多种治法结合,并依据兼夹邪气随证加减,后期治疗时以养阴清余热为主,并注意顾护脾胃。该文将疫病、伤寒、温病3种外感病进行区别的目的是使医务工作者治疗现代疫病时有证可依、有的放矢。Epidemiology has a unique theoretical system.Epidemics is a type of acute exogenous disease caused by miscellaneous Qi.Miscellaneous Qi is not the six exogenous pathogens and does not have attributes such as cold,hot,warm,and cool.However,it can also contain six pathogenic factors such as wind,cold,heat,dampness,dryness,and fire.The miscellaneous Qi enters from the mouth and nose,and lies in the membrane or middle Jiao.The forms of transmission and transformation include the nine meridians on the surface and inside,the three Jiao transmission and transformation,the twelve meridians transmission and transformation,and the six meridians transmission and transformation.The essence of its pathogenesis is internal heat stagnation,and the treatment is mainly focused on clearing internal heat.During the Ming and Qing Dynasties,epidemiologists took clearing internal heat as the basic treatment principle,developed the two methods of sweating and sweating,and expanded the sweating method to the method of seeking sweat.Through various treatment methods,they achieved the goal of promoting Qi circulation,allowing sweat to emerge naturally,and merging evil with sweat.The method of treating diseases does not restrict the formation of feces,and puts forward concepts such as“never tire of getting rid of the epidemic early”and“when the epidemic subsides,it becomes stagnant heat”.From the perspective of principles,formulas,and medicine,it distinguishes diseases from typhoid fever and warm diseases,and proposes that diseases are not typhoid fever,nor do they belong to the scope of warm diseases.The theory of epidemiology still has guiding significance for the treatment of infectious diseases by the authorities.Epidemic treatment focuses on expelling pathogenic factors and combining various treatment methods such as clearing heat and attacking the lower body.It is also based on the combination of pathogenic factors and syndrome differentiation.In the later stage of treatment,the main focus is on nourishing Yin and clearing ex

关 键 词：疫病 治则 伤寒 温病 杂气 

分 类 号：R254[医药卫生—中医内科学]