“因毒生热”——毒热理论体系的构建与发展
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摘要
通过阐述中医学毒与热的含义、毒热理论的形成与发展,毒热物理、生物、化学的演变过程,探讨毒热的来源、病因病机。毒热比热毒的范围更广,毒、热可互为因果,互相转化;其病因为因毒而热,病机或为玄府闭塞,寒郁化热;或伏邪蕴蓄,化毒生热;或杂气瘟疫,感毒化热;或毒邪内生,热发于外。中医"毒热"理论与毒热的现代生物学研究彼此深度融合,毒热理论可用于理解指导治疗现代临床疾病。临床实践中,不应将西医炎性疾病同中医的"热毒"相等同,可将其放在中医"毒热"的理论体系框架中,根据毒热具体的病因病机,审证论治。
The present study explores the origin of toxin heat theory, and its etiology and pathogenesis by expounding the meaning of toxin and heat in traditional Chinese medicine(TCM),its formation, developmentand the evolution process from physics, biology and chemistry. Compared with heat-toxic theory, we believe that toxin heat theory encompasses a wider range of comprehensive concepts, the cause of which is heat due to toxin. Its pathogenesis may be the invasion of cold evil, occlusion of Xuanfu, heat produced by stagnationor suffering external toxic evil, latent occurringor toxin heat caused by implication of evil Qi and plagueor heat produced by endogenous toxicity. Besides, it is worthy to note that the concept and understanding of the toxin heat theory is consistent with its modern biological basis. Moreover, we also point that it should be avoided to mechanically equate the inflammatory disease in western medicine with the heattoxin theory in TCM, but should be considered in the framework of toxin heat theory in the clinic. At last, the specific therapy can be carried out according to the specific pathogenesis and pathogenesis of toxin heat.
The present study explores the origin of toxin heat theory, and its etiology and pathogenesis by expounding the meaning of toxin and heat in traditional Chinese medicine(TCM),its formation, developmentand the evolution process from physics, biology and chemistry. Compared with heat-toxic theory, we believe that toxin heat theory encompasses a wider range of comprehensive concepts, the cause of which is heat due to toxin. Its pathogenesis may be the invasion of cold evil, occlusion of Xuanfu, heat produced by stagnationor suffering external toxic evil, latent occurringor toxin heat caused by implication of evil Qi and plagueor heat produced by endogenous toxicity. Besides, it is worthy to note that the concept and understanding of the toxin heat theory is consistent with its modern biological basis. Moreover, we also point that it should be avoided to mechanically equate the inflammatory disease in western medicine with the heattoxin theory in TCM, but should be considered in the framework of toxin heat theory in the clinic. At last, the specific therapy can be carried out according to the specific pathogenesis and pathogenesis of toxin heat.
引文
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[15] 王利军,张莹.中药联合亚胺培南-西司他丁钠治疗重症细菌感染的临床观察[J].中国中医药科技,2014,21(6):681-682.
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[2] 邵文彬,朱丽红.温病“毒”邪初探[J].中华中医药学刊,2005,23(12):2221-2222.
[3] 胡渊龙.浅析热毒[J].世界最新医学信息文摘,2016,16(90):258.
[4] 贾丁,齐艳平,高森.试论热证的分型与中药治则[J].中国实用医药,2012,7(23):231-232.
[5] 王兴,张玲,庞芳,等.浅谈《内经》热病理论[J].四川中医,2017(2):26-28.
[6] 朱寒阳.伏气致病与痛风性关节炎的关系探讨[J].世界中西医结合杂志,2010,5(9):737-738.
[7] 黄竹青,郑剑玲,齐贺.真菌作为消化性溃疡的内痈“毒热”因子的检测分析[J].中华中医药学刊,2012,30(6):1225-1228.
[8] 陈永,李亚明,管剑龙.白塞病的中西医结合病理机制[J].中国中医基础医学杂志,2018(1):28-30.
[9] 陈春雷,李兰娟.感染微生态学的研究进展[J].国际流行病学传染病学杂志,2005,32(5):271-273.
[10] 王文丽.毒热证浅析[J].中医儿科杂志,2009,5(2):7-9.
[11] 杨景青,朱雪,李莹莹,等.从毒邪特点浅析肺间质纤维化病机[J].河北中医药学报,2013,28(1):7-8.
[12] 周学文,肖景东.创新“毒热”理论以痈论治消化性溃疡[J].中华中医药学刊,2008,26(6):1166-1168
[13] 由凤鸣,郑川,祝捷,等.从“火郁发之”论治放射性肺损伤[J].中医杂志,2015,56(21):1819-1821.
[14] 柳金英,任莹璐,任卫全,等.从炎性反应角度探讨清热解毒法治疗心力衰竭的意义[J].中华中医药杂志,2017(11):4901-4905.
[15] 王利军,张莹.中药联合亚胺培南-西司他丁钠治疗重症细菌感染的临床观察[J].中国中医药科技,2014,21(6):681-682.
[16] 于洋.脓毒血症的中医辨证及中西医结合治法[J].医学信息,2017,30(2):23-24.
[17] 周彩云.房定亚学术思想探析[J].北京中医药,2013,32(11):814-815.
[18] 陈云逸.辨析温病学中"毒"的含义及其证治[J].西部中医药,2006,19(2):1-2.
[19] 刘桂蕊.炎症(Inflammation)(1)[J].医学综述,2005,11(1):1-3.
[20] 史大卓,谢仁明,王永炎.现代温热病卫气营血辨证的重新思考[J].中医杂志,2005,46(2):86-87.