从《温病条辨·上焦篇》第16条探讨“太阴温病”之误诊误治  

Exploration of Misdiagnosis and Mistreatment of"Taiyin Febrile Disease"from Article 16 of Shangjiao Section of the"Treatise on Differentiation and Treatment of Epidemic Febrile Diseases"

作　　者：田玉肖 陈聪文 孙维旭 TIAN Yuxiao;CHEN Congwen;SUN Weixu(The Second Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China;Department of Pulmonary Diseases,Puyang Hospital of Traditional Chinese Medicine Affiliated to Henan University of Traditional Chinese Medicine,Puyang,Henan 457003,China)

机构地区：[1]河南中医药大学第二临床医学院,郑州450046 [2]河南中医药大学附属濮阳市中医医院肺病科,河南濮阳457003

出　　处：《临床误诊误治》2025年第6期28-32,共5页Clinical Misdiagnosis & Mistherapy

基　　金：国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕1号);河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才(豫卫中医函〔2021〕15号)。

摘　　要：《温病条辨·上焦篇》第16条主要讲述的是“太阴温病”的误诊误治。结合叶天士、吴鞠通、赵绍琴等温病大家的理论,认为“太阴温病”即“呼吸道症状明显的发热性疾病”,也是临床的常见病和多发病。由于太阴温病也会伴有“发热、恶寒、无汗”,所以,常会被误诊为伤寒,而错误地使用辛温解表发汗药,因此需要进行伤寒与温病的鉴别。如果使用汗法去治疗“太阴温病”,除了会导致发斑、发疹,甚至神昏谵语,逆传心包之外,对于“发汗不过多”者,还可能会出现病情好转的假象。通过深入剖析这则条文,对于提升鉴别诊断的能力,可减少误诊误治,提高疗效。Objective Article 16 of Shangjiao Section of"Treatise on Differentiation and Treatment of Epidemic Febrile Diseases"mainly introduces the misdiagnosis and mistreatment of"Taiyin febrile diseases".According to the theories of Ye Tianshi,Wu Jutong,and Zhao Shaoqin,Taiyin febrile disease is a febrile disease with obvious respiratory symptoms,which is also a common and frequently-occurring disease in clinical practice.Because Taiyin febrile disease is also accompanied by"fever,aversion to cold,no sweating",it is often misdiagnosed as typhoid fever,which is usually mistakenly treated with Xinwen Jiebiao Fahan drugs.Therefore,it is necessary to distinguish typhoid fever and febrile disease.If the sweat method is used to treat"Taiyin febrile diseases",in addition to causing freckles,rash,and even dizziness and delirium,reverse transmission to the pericardium,for those who do not sweat too much,there may be an illusion of improvement.Through in-depth analysis of this provision,it has certain guiding significance in clinical practice for improving the ability of differential diagnosis,reducing misdiagnosis and missed diagnosis,and improving curative effect.

关 键 词：温病条辨 太阴温病 误诊 伤寒 逆传心包 诊断 鉴别 治疗失误 

分 类 号：R256[医药卫生—中医内科学]