| 摘要: |
| 东汉张仲景所著《伤寒杂病论》一书中，虽没有后世疫病之名目，却真实记载了大量辨治疫病之证治方药的条文及案例经验。笔者抚今追古，重温经典，结合自己多年的临床经验及其体认，并引证了当代诸多医家名宿之论，认为《伤寒论》堪称我国古代疫病防治的奠基之作。《伤寒论》虽以辨治寒疫及寒湿疫为主，但也包括湿热类、热毒类及瘀毒类疫病的证治。其所论及疫病的类型及疑似病种，寒湿类疫病主要包括：流行性感冒及其并发呼吸道和消化道感染，流行性脑脊髓膜炎，流行性腹泻（寒性）及寒性霍乱，流行性出血热等急性传染病；温热类疫病最为确定的是“黄疸”和“下利”，其证候与现代所谓急性病毒肝炎和急性细菌性痢疾基本相同；该书还开示了辨治热毒疫、瘀毒疫之法门，对后世影响深远。笔者还从《伤寒论》全篇整体分析，体悟到张仲景以“正邪博弈”为核心理念辨治外感疫病的思想，分别采取以祛邪为主、以扶正为主或以祛邪扶正并重的治则大法；并开创了病证结合、以辨证论治为主的中医诊疗模式。 |
| 关键词: 疫病 寒湿疫 温热疫 瘀毒疫 《伤寒论》 奠基之作 |
| DOI： |
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| Treatise on Febrile and Miscellaneous Diseases is the foundation work of traditional Chinese medicine diagnosing and treating epidemiology (Ⅰ) |
| YUAN Changjin |
| (The Second Affiliated Hospital of Hunan University of Chinese Medicine，Changsha 410005， Hunan， China) |
| Abstract: |
| In the book of Treatise on Febrile and Miscellaneous Diseases written by Zhang Zhongjing in the Eastern Han Dynasty， although there are no names of epidemic diseases in later generations， it truly records a large number of items and case experience in the syndrome differentiation-based treatment of epidemic diseases. With reference to his own clinical experience and understanding for many years， the author focuses on the present， revisits the classics， cites the theories of many famous contemporary doctors， and believes that Treatise on Febrile and Miscellaneous Diseases can be regarded as the foundation for the prevention and treatment of ancient epidemic diseases in China. Although Treatise on Febrile and Miscellaneous Diseases mainly describes the syndrome differentiation-based treatment of cold epidemics and cold-damp epidemics， it also includes the traditional Chinese medicine (TCM) syndromes and treatment of damp-heat， heat-toxin， and stasis-toxin epidemics. As for the types of epidemic diseases and suspected diseases mentioned in this book， cold-damp epidemics mainly include acute infectious diseases such as influenza and related respiratory and gastrointestinal infections， epidemic cerebrospinal meningitis， epidemic diarrhea (cold) and cold cholera， and epidemic hemorrhagic fever;“jaundice” and “diarrhea”are the most definite warm epidemics， and their syndromes are basically the same as those of acute viral hepatitis and acute bacillary dysentery in modern times. The book also reveals the methods for the treatment of heat-toxin epidemics and stasis-toxin epidemics， which has a far-reaching influence on later generations. Through an overall analysis of Treatise on Febrile and Miscellaneous Diseases， the author realizes the thought of Zhang Zhongjing in treating exogenous diseases with the core concept of “the struggle between vital Qi and pathogen”， with the main principles of eliminating pathogen， strengthening vital Qi， or emphasizing both pathogen-eliminating and vital Qi-strengthening therapies， thereby establishing a TCM diagnostic and therapeutic mode of combining disease and syndrome and performing syndrome differentiation-based treatment. |
| Key words: epidemic disease cold-damp epidemic warm epidemic stasis-toxin epidemic Treatise on Febrile and Miscellaneous Diseases Foundation work |
