基于疫邪肺胃传变规律探析疫病发热证治模式  

Syndrome Differentiation and Treatment Model for Fever Syndromes in Epidemic Diseases Based on Transmission Law of Pathogenic Factors between Lung and Stomach

作　　者：田栋 张潇逸 廖书琴 黄明瑜 周润琳 李欣 王维广 陈子杰 翟双庆 TIAN Dong;ZHANG Xiaoyi;LIAO Shuqin;HUANG Mingyu;ZHOU Runlin;LI Xin;WANG Weiguang;CHEN Zijie;ZHAI Shuangqing(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学中医学院,北京100029 [2]北京中医药大学东直门医院,北京100700

出　　处：《河北中医药学报》2025年第2期13-17,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：国家重点研发计划项目(2018YFC1704100);科技部科技基础资源调查专项(2022FY102000);中央高校基本科研业务费专项资金资助(2022-JYB-JBZR-011)。

摘　　要：疫病发热为疫邪导致的外感发热。因疫邪为毒的特殊性,其从口鼻而入,传变规律和六淫邪气有所不同。各医家对于疫邪的传变规律,各有侧重和阐发。《温病条辨》有言:“鼻气通于肺,口气通于胃。”阐发温疫邪气从口鼻而入,直侵肺胃的本质。此理论侧重邪气从口鼻而入,于肺胃传变,符合现代传染病的致病特点。本文进一步探究疫邪肺胃传变规律认为,疫邪从口鼻而入,首先中于肺胃,弥散三焦;进而疫邪发生传变,其顺传主要有二:一为疫邪顺传至皮肤肌表,二为疫邪顺传至下焦肠腑;其逆传为一:疫邪逆传心包,上至膻中,易发重症。疫邪肺胃传变规律与疫病发热的阶段密切相关,疫病早期发热多为疫邪中肺胃散三焦而致,发热迁延不愈多有肠腑留邪之患,发热重症伴神志异常多提示疫邪从肺发生逆传。因此本文依据疫邪肺胃传变规律构建疫病发热的证治模式,明确了疫病发热与疫邪肺胃传变病位的联系,以期为疫病发热的精准祛邪治疗提供思路。Fever in epidemic diseases is an exogenous fever caused by pathogenic epidemic factors which enter the body through the nose and mouth,and their transmission law is different from that of the six exogenous pathogenic factors.Different physicians have their own emphases and elaborations on the transmission law of pathogenic epidemic factors.In Systematic Differentiation of Warm Diseases(Wēn Bìng Tiáo Biàn),it is stated that"The qi of the nose connects with the lung,and the qi of the mouth connects with the stomach."This expounds the essence that the pathogenic factors of warm epidemic diseases enter through the nose and mouth and directly invade the lung and stomach,which is in line with the pathogenic characteristics of modern infectious diseases.This article further explores the transmission law of pathogenic epidemic factors between the lung and stomach and believes that the pathogenic epidemic factors enter through the nose and mouth,first attack the lung and stomach,and spread throughout the triple energizers.Then,the pathogenic epidemic factors undergo transmission and change.There are mainly two types of sequential transmissions:one is that the pathogenic epidemic factors sequentially transmit to the skin and muscles,and the other is that the pathogenic epidemic factors sequentially transmit to the lower-jiao intestines.There is one type of reverse transmission:the pathogenic epidemic factors reversely transmit to the pericardium and reach the central chest(Danzhong),which is likely to lead to severe cases.The transmission law of pathogenic epidemic factors between the lung and stomach is closely related to the stages of fever in epidemic diseases.Fever in the early stage is mostly caused by the pathogenic epidemic factors attacking the lung and stomach and spreading throughout the triple energizers.If the fever persists without recovery,there is often the problem of the pathogenic factors remaining in the intestines.Severe cases of fever accompanied by abnormal mental states often indicate that the pat

关 键 词：发热 疫病 《温病条辨》 传变 

分 类 号：R254[医药卫生—中医内科学]