《伤寒论》“厥热胜复证”的探讨
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摘要
基于《伤寒论》原文,结合现代临床实际,对厥热胜复证和厥阴病以及各类厥证的不同内涵进行了辨析。厥热胜复证是以手足逆冷与发热交替出现为特征性表现的病证,是见于外感病危重阶段正邪交争过程中的一种特殊临床表现。若正气欲脱,则以手足逆冷为突出表现;若正复脱回,则以邪热亢盛为主要矛盾。临床可见于严重感染所致的感染中毒性休克,如中毒型菌痢等。结合现代医学来认识,此时出现的四肢厥冷已经属于休克的表现,若休克能够得到及时纠正,而原发感染未愈,或并发其他感染的,则以发热为主要表现。理解厥热胜复证的内涵,对于指导现代临床,尤其是急危重症的救治具有重要意义。
Based on the original text of Shanghan Lun and the modern clinical practice, to distinguish the different connotations of syndrome of alternate cold and heat and Jueyin disease as well as several Jue syndromes. Syndrome of alternate cold and heat is a special clinical manifestation occurred in the process of severe infections, such as toxic bacillary dysentery,which is characterized by the alternation between fever and the low temperature of limbs. If the vital qi is going to collapse, the low temperature of limbs is the outstanding manifestation; if the vital qi is recovered, the main manifestation is the fever. Clinically, it can be seen in toxic shock caused by severe infection, such as poisonous bacillary dysentery. In combination with modern medicine,the appearance of cold limbs at this time is already a manifestation of shock. If shock can be corrected in time, and the primary infection is not cured, or other infections are concurrent, fever is the main performance. Understanding the connotation of syndrome of alternate cold and heat is useful for guiding clinical treatment, especially for those urgent and severe cases.
Based on the original text of Shanghan Lun and the modern clinical practice, to distinguish the different connotations of syndrome of alternate cold and heat and Jueyin disease as well as several Jue syndromes. Syndrome of alternate cold and heat is a special clinical manifestation occurred in the process of severe infections, such as toxic bacillary dysentery,which is characterized by the alternation between fever and the low temperature of limbs. If the vital qi is going to collapse, the low temperature of limbs is the outstanding manifestation; if the vital qi is recovered, the main manifestation is the fever. Clinically, it can be seen in toxic shock caused by severe infection, such as poisonous bacillary dysentery. In combination with modern medicine,the appearance of cold limbs at this time is already a manifestation of shock. If shock can be corrected in time, and the primary infection is not cured, or other infections are concurrent, fever is the main performance. Understanding the connotation of syndrome of alternate cold and heat is useful for guiding clinical treatment, especially for those urgent and severe cases.
引文
[1][日]丹波元坚.伤寒论述义.北京:人民卫生出版社,1956:26
[2]刘渡舟,郝万山.学习《伤寒论》厥阴病篇的一点体会.河南中医,1981(3):11-13
[3]李培生.李培生伤寒论讲稿.北京:人民卫生出版社,2010:42
[4]祝味菊.伤寒质难.北京:学苑出版社,2011:140
[5]钱超尘.伤寒论文献通考.北京:学苑出版社,1993:453
[6]贾春华,王海林.《伤寒论》研究的反思.中国中医基础医学杂志,1995,1(4):48-49
[7]赵进喜,王富龙.《伤寒论》与中医现代临床.北京:人民军医出版社,2006:7
[8]赵进喜.《伤寒论》“厥阴病”析疑.山东中医药大学学报,2005,29(2):100-101
[9]俞根初,徐荣斋.重订通俗伤寒论.北京:中国中医药出版社,2011:209
[10]时振声.对《伤寒论》厥阴病的看法.新医药学杂志,1979(6):51-55
[2]刘渡舟,郝万山.学习《伤寒论》厥阴病篇的一点体会.河南中医,1981(3):11-13
[3]李培生.李培生伤寒论讲稿.北京:人民卫生出版社,2010:42
[4]祝味菊.伤寒质难.北京:学苑出版社,2011:140
[5]钱超尘.伤寒论文献通考.北京:学苑出版社,1993:453
[6]贾春华,王海林.《伤寒论》研究的反思.中国中医基础医学杂志,1995,1(4):48-49
[7]赵进喜,王富龙.《伤寒论》与中医现代临床.北京:人民军医出版社,2006:7
[8]赵进喜.《伤寒论》“厥阴病”析疑.山东中医药大学学报,2005,29(2):100-101
[9]俞根初,徐荣斋.重订通俗伤寒论.北京:中国中医药出版社,2011:209
[10]时振声.对《伤寒论》厥阴病的看法.新医药学杂志,1979(6):51-55