气象环境对温病发病影响的研究
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摘要
我国特有的地理位置与地形分布,形成了独有的风、温、暑、湿、燥、寒季节性气候韵律。地理气候环境影响疾病发生及体质形成,在我国古代医籍中不乏相关论述。地理、气候、生态、产出、乃至人类的饮食、体质、疾病与证治各有异同,然而与其自身的环境系统是一致的。现代医学研究亦从分子生物学、免疫学、生物化学、基因组学等角度印证了这一思想。气候环境的差异影响疾病的病种分布与流行,对外感热病病程及其转归的影响不但是古代医家认识病性的重要依据,也是形成温病治法方论的重要基础。
     大多数的急性感染性疾病都隶属于温病范畴,而众所周知,急性感染性疾病的季节性和周期性主要是由气候和环境因素决定的。现代由于环境污染、生态恶化、气候异常变化,使得感染性疾病的发生与流行出现新的态势。全球变暖对人类健康的影响作用不可低估,近年来的研究表明,频现的暖冬气候不但降低了机体适应气候的能力,而且有利于微生物及其媒介越冬,易于形成雾日影响污染物扩散,使经由呼吸道感染的疾病发病增加。而厄尔尼诺现象造成的海洋温度变化,引起大气环流异常,一方面致干旱和洪涝灾害频发,使疫源易于扩散,相当多的研究表明,厄尔尼诺现象与呼吸道传染病、肠道传染病、血液传染病、各种虫媒传染病的流行相关;另一方面,致空气微生物菌相变化,生物媒介及其病原体生长异常,甚则变异,使新的传染病(如SARS、人禽流感等)层出不穷。
     应该用历史的观点来看待中医学的外感病因学说。不同医家对病因的认识是受到医家所居、所见、所识、所感及当时的社会认识水平所限的。六淫说是中医病因学说的重要组成部分,其概念形成源于对气候环境的认识。在中医病因认识发展过程中,“六淫”学说有着不同的内涵和外延。六淫病因包括气候环境因素和物质性病因,其内涵包括三层含义:一是季节性的环境致病因素,二是病原性生物的致病因素,三是审证求因后的病因概括。正常或异常气候皆可影响人体健康,是六淫或六气为病的气象学基础,极端气象条件是六淫“过则为灾”致病的本质,主要气象因子的直接刺激作用是“六淫”为病的生理病理学基础之一,“积渐、浸淫”是六淫为病的主要作用方式,而“非时之气为病”则是气候异常致病的经验总结。
     温病病因学说是我国古代医家对气象环境因素所致外感热病认识的发展,自《内经》始提出外感热病病因是“冬伤于寒”,即感寒伏邪说,后世有六淫化火论,时气与戾气说,直到吴又可提出杂气论,才将物质性病因从六淫病因中剥离出来,使外感病因明确为气候因素与物质性病因。
     自然界的“清气”是维持后天生命的基本物质之一。由于现代工业发展,环境恶化,颗粒物及微生物气溶胶,大气中新增的气态污染物、环境电离辐射等使“温邪”为病不容忽视。“臭毒”是我国传统医学对环境污染致病的最初认识,古称“秽浊”、“龌龊”,现包括生物腐败物和气态污染物。“温邪上受,首先犯肺”的实质与空气感染有关,其中颗粒物是空气感染的主要载体,微生物气溶胶是“温邪”传播的主要形式。其中急性放射损伤临床表现出具有伏气温病里热外发的典型特征,但病因确属外感,而且发病急骤,营血分见证快,故归之于“疠气”病因范畴。
     中医学对气象条件与疾病关系的认识主要包括:①气象环境的病因作用,②疾病的季节倾向,③气候及天气变化对人体疾病发生及其病程尤其是临床表现的影响。温病的发生因其具有明显的季节性,故有“时病”之称。由于四时主气不同,所形成的温邪各有特性,致人发病也有各自特点。气候环境因素影响温邪作用于疾病发生的各个环节,如感邪途径,病原体的生长、繁殖与传播以及污染物的扩散与稀释等。气候环境因素不仅直接影响机体的生理机能状态,使机体对疾病的感受性有所变化,形成人体的节律性效应;同时也影响人体的病理过程,使疾病的发生与临床表现具有典型的时令特征;对温病的病种分布、临床症候及其传变、预后也有一定影响。温病学说是我国传统医学对感染性疾病认识与防治的经验积累,强调疾病的时令性,重视季节性气象因子对疾病发生及病情机转的影响。温病学中的卫气营血辨证、三焦辨证的创立就是对感染性疾病证治的科学概括。四时温病理论亦为气候环境因素诱发感染性疾病提供了辨证论治的临床依据。对感染性疾病发生的时气节律及其内在关联性进行探析,是应用四时温病学说进行防治的基础。温病学理论在感染性疾病的治疗方面,已日臻成熟,并已形成系统的治法方论。天地人三者之间的交互作用,对病邪的发生和消长,尤其对疾病的发生发展过程有着相当重要的影响,因此,与气候环境因素有关的疾病,凡是在病程中出现“热”、“瘀”等病理环节或动血、生风、阴液损伤等病理征象的,都可参照温病治法进行治疗。可见,应用四时温病学说防治心脑血管疾病、变态反应性疾病、肿瘤、环境“毒”致病,既是对“知时论证”的继承与发扬,也是我国传统气象医学今后研究的重点。
     气候环境对古今疫病的流行影响作用不同,气候异常或者灾害性天气所带来的饥荒、战乱,是古代催生疫病流行的主要因素;现代人类抗灾减灾能力提高,气候因素的影响不再是疾病爆发的主要原因,而退行性疾病,人为因素带来的新疾病,是现代疾病模式的主力军。古往今来,气候、环境不断变迁,从而使温病流行具有不同的时代特征,明确气候环境与人类疾病的相关性及其作用机制,不仅是四时温病防治的重要内容,对于更好的应对新传染病的层出不穷,有着不可低估的现实意义。加强不同层次的合作交流尤为必要,气候的任何变化都将对环境、生物、社会经济和公共卫生产生深远的影响。应当深入探讨应用气候学、生物学和流行病学、温病学知识及其相互关系,进一步调查温度、海面升高、其他气候因素与病原相关的生态学联系,推动多学科的综合性研究。
The special climate changed punctually, presented seasonal rhythm, as a result ofparticular geographical position and hypsography in our country. There are manycorrelative dissertation in ancient works of Traditional Chinese Medicine (TCM) about theinfluence of geographical, climatic and environmental factors on occurrence of disease andconstitution of human body. The modern research also conformed this thought by molecularbiology, immunology, biochemistry and genomics etc. The qualitative relationship betweenthe prevalence and distribution of epidemic disease and the diversity of climatic conditionbecame gist when some doctors of TCM giving their diagnosis. It's important that thediversity of climatic condition affected the course of exogenous febrile disease duringtreatment and selecting preseription..
     Most of acute infectious diseases belong to the category of epidemic febrile diseases.And it is universally knowledge that the seasonal periodicity of febrile disease relies onclimate and environment. Recently due to pollution, deterioration of entironment and globalwarming, the prevalence of infectious diseases take on new featuers. Especially winterwarming not only lowered the adaptibility that human being has adapted well to cold winterclimes, but also increased the chances that microorganism and some host live thought thecold winter. Soupy weather affected the diffusion of pollution, increasing the infection ofrespiratory disease .El Nino phenomenon induced calefactive ocean and abnormalatmospheric circulation. With drought and floods bringing on E1 Nino, pestilential pathogenbecame widely spread easily. Biological vector developed abnormally. The upgrowth andaberrance of pathogens and propagates brought new infectious diseases (such as SevereAcute Respiratory Syndrome, Avian Influenza A/H_5N_1) to break out more frequently.
     The theory of six exopathogen is the etiology of Traditional Chinese Medicine. Itcomes from the six climatic factors, including wind, cold, summer-heat, dampness, drynessand fire .During the course of the theory of six exopathogen developing, the theory of sixexopathogen has different connotation and extension. The six exopathogen contains not only climatic and environmental factors, but also biologic and chemical and physicalfactors. It contains three aspects: the first is seasonal natural circumstances. The second isbiologic Pathogens. The third is ascertained pathogen by syndrome differentiation. Normaland abnormal climatic condition all affecting human body is meteorological nature ofdisease caused by six exopathogen. Extreme meteorological conditions are related closelywith eliminating the exopathogen from the interior to the superficies. The action of chiefmeteorological factors is the basis of exopathic disease, due to activating physiological andpathological direct reaction swiftly or being in effect for a long time. The conclusion aboutabnormal climate induced diseases imputed unpunctual for climate.
     The theory of seasonal epidemic febrile diseases developed from the cognition ofancient medical scholars about meteorological and environmental factors inducedexogenous febrile diseases in China. There is a original thesis that environmental coldpathogens in winter brought on pathogenic and febrile diseases in NeiJing(Canon ofInternal Medicine). That means invasion of cold pathogen or insidious pathogen due toinvasion of cold pathogen. From then on, there are many theories about exogenous factorsof epidemic febrile diseases, such as the theory about six climatic factors transform intoheat, the theory of seasonal pathogen, the theory of pestilential pathogen. Till Wu Youkeraised a point of pestilential pathogen, most of medical scholars realized exogenous factorsof epidemic febrile disease contains meteorological factors and biologic factors, somephysical and chemical efficient amse.
     Natural fresh air is one of the basic materials that maintain postnatal life. And nowwith the developing of modern industry, deteriorating of environment, more and moregranule, gaseous nocuousness spreaded out in the air. Aerosol of microorganism andradicalization resulted new febrile diseases. Fuchou is the original cognition aboutenvironmental pollution induced diseases. In ancient works, mephitis has different names,contains biologic putrefaction and gaseous contamination. Atmospheric infection is thesame way with warm-heat pathogen usually invades the upper from the mouth and noseinto the lung and the defensive Qi. And the dominating carriers of atmospheric infection aregranules. Microorganism aerosol is the main pattern of warm-heat pathogen spreading out.Especially acute radiation sickness took on interior heat syndrome of excess type, just likeseasonal febrile diseases which caused by insidious pathogenic factors. So radicalizationshould belong to the category of pestilential pathogen.
     The cognition in TCM about the relationship between meteorological and environmental factors and diseases mainly includes three aspects. The first ismeteorological and environmental factors activating physiological and pathologicalreaction. The second is diseases coming on seasonally. The third is the change of climateand weather influence clinical presentations. Epidemic febrile disease is also calledseasonal disease. Due to different climatic conditions in one year, different warm-heatpathogen represented different characteristic and brought on different diseases.Meteorological and environmental factors affected every sticking point, includingpathogenic routes, growth, reproduction and spread of microorganism , and pollutantgranule diffusing and diluting. Meteorological and environmental factors impacted humanphysiological and pathological process, changed susceptibility of human body to febrilediseases, presented typical seasonal features. Meteorological and environmental factors stillaffected distribution, clinical presentations, transference of infectious diseases. Withclimate and environment changed in history, the prevalence of seasonal febrile diseasesexhibited different characteristics of the epoch. To deal with new febrile diseases breakingout more frequently, it is important to make clear the capability of meteorological andenvironmental factors causing disease by breaking down protective mechanisms of thehost, the correlation between meteorological and environmental factors and seasonal febrilediseases.
引文
[1] 李铁君,陈燕燕.中医气象学与养生防病·干祖望序[M].北京:人民卫生出版社,1994,3
    [2] piazza A, Menozzi P, Cavalli - Sforza LL. The HLA - A, B gene frequencies in the world migration or selection. Human Immunol, 1980, 1(4): 297-304
    [3] Gelfgat EL, Lozovoi VP, Konenkor VI. Demographic aspects of adaptive changes of human immune system in the North Vets [J]. Ross Akad Med Nauk, 1993, (8): 20-25
    [4] Ezeamuzic CI, AL-ALS, Knan M, et al. IgE-mediated sensitization to mould allergens among patients with al21ergic respiratory disease in a desert environment[J]. Int Arch Allergy Immunol, 2000, 121(4): 300-310
    [5] Ezeamuzie CI, al-Mousawi M, Dashti H, et al. Prevalence of allergic sensitization to inhalant allergens among blood donors in Kuwait-a desert country[J]. Allergy 1997, 52(12): 194-200
    [6] Dowaisan A, Al-Ali S, khan M, et al. sensitization to aeroallergens among patients with allergic rhinitis in a desert environment. Ann Allergy Asthma Immunol, 2000, 84:1503-1513
    [7] Falkenbach A, Sedimeyer A. Travel to sunny countries is associated with changes in immunological parameters Photodermatol photoimmunol[J]. PHOTOMED, 1997, 13: 135-139
    [8] 林乔:王米渠.《宋史》人物遗传疾病和环境对寿限的影响[J].遗传学报.2000:27(12):1049-1056
    [9] Goyette P, Rozen R. The thermo labile variant 677C-T can further reduce activity when expressed in cis with severe mutations for human methylenetetrahydrofolate reductase [J]. Hum Mutat, 2000, 16(2): 132-138.
    [10] Rossi L, Whitecomb DC, Ehrlich GD, et al. Latch of R_(117)H mutation in the cationic trysinogen in patients with tropical pancreatitis from Bangladesh. Pancreas, 1998, 17 (3): 228-232
    [11] 何宗旺译.《左传·宣公15年》.新疆:新疆人民出版社,2002,1:271
    [12] http://www.dushu.com/showbook/100172/1006376.html
    [13] 宋·温革.《分门琐碎录》.上海:上海图书馆影印本,1962
    [14] 三国魏·嵇康.《养生论》.北京:人民卫生出版社,1990,7:3
    [15] 南北朝·陈延之.《小品方·治瘿病诸方》.北京:中国中医药出版社出版,1995,6:222
    [16] 唐·孙思邈.《千金翼方第十四·退居·择地第一》.北京:中国中医药出版社出版,1998,12:670
    [17] http: //www3.zzu.edu.cn/qts/
    [18] 唐·孙思邈.《千金翼方卷第一·药录纂要》.北京:中国中医药出版社出版,1998,12:519-524
    [19] 隋·巢元方.《诸病源候论·瘴气候》.北京:人民卫生出版社影印本,1982:六四
    [20] 清·王孟英.《霍乱论》十四页.含经室光绪戊子(1888)春校刻本
    [21] 清·张璐.《张氏医通》卷上.上海:上海科学技术出版社,1963,41
    [22] 晋·陈寿.《三国志·吴书·全琮传》.北京:中国文史出版社,2003,5:333
    [23] 晋·陈寿.《三国志·吴书·陆逊传》.北京:中国文史出版社,2003,5:324
    [24] 晋·陈寿.《三国志·吴书·陆凯传附弟胤传》.北京:中国文史出版社,2003,5:341
    [25] 竺可桢.中国近五千年来气候变迁的初步研究[J].考古学报,1972,1:15
    [26] 清·何梦瑶.《医碥·赵序》载《中华医书集成(三十):综合类9》.北京:中医古籍出版社,3
    [27] 薛清录.全国中医图书目录[M].北京:中医古籍出版社,1991:371-406
    [28] 赖文,李永宸.东汉末建安大疫考:兼论仲景《伤寒论》是世界上第一部流行性感冒研究专著[J],上海中医药杂志,1998,32(8):2-6
    [29] 胡国臣主编.明清名医全书大成·吴鞠通医学全书·吴鞠通医医病书·三元气候不同论[M].北京:中国中医药出版社,1998:144
    [30] 元·朱震亨.《丹溪心法》.北京:中国书店,1986:1
    [31] 民国·何廉臣.《增订通俗伤寒论·六经方药》.福州:福建科学技术出版社,2004,5:67
    [32] 清·徐大椿.《医学源流论·五方异治论》载《中华医书集成(二十):医论医案医话类一》.北京:中医古籍出版社,24
    [33] 宗和.应对气候变暖生态恶化·中国气候战略即将出台.扬子晚报,2007,2,8:A9
    [34] http://www.smg.gov.mo/smg/tec_report/powerpoint/elnino_2004/wmd2004.ppt#261,3,幻灯片3
    [35] 王力健.厄尔尼诺现象与传染病.城市防震减灾,1998,2:2—5
    [36] NaidooA, PatricK. Cholera: a continuousepidemicinAfrica[J]. J R Soc Health, 2002,122 (2): 89-94
    [37] Anonymous. Cholera in 1997[J]. Wkly Epidemiol Rec, 1998, 72 (27): 201-208.
    [38] Kunii O, Nakamura S, Abdur R, et al. The impact on health and riskfactors of the diarrhoea epidemics in the 1998 Bangladesh floods[J]. Public Health, 2002, 116(2): 68-74.
    [39] http://www.bioon.com/Article/clinic08/57688.shtml
    [1] 明·吴有性.《温疫论·杂气论》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:26
    [2] 金·刘完素.《素问病机气宜保命集·气宜论第八》载《金元四大医学家名著集成》.北京:中国中医药出版社,1995,10:116
    [3] 明·缪希雍.《神农本草经疏》.北京:中医古籍出版社,2002,19
    [4] 何宗旺译.《左传·宣公15年》.新疆:新疆人民出版社,2002,1:501
    [5] 《辞海》上海辞书出版社:1979:2208
    [6] 宋·陈言(字无择).《三因极—病症方论·三因论》[M].北京:人民卫生出版社,1983,19-20
    [7] 明·吴有性.《温疫论补遗·伤寒例正误》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:43
    [8] 清·高世栻.《医学真传·原病》载《中华医书集成(二十):医论医话医案类一》.北京:中医古籍出版社,6
    [9] 明·张介宾.《景岳全书·暑证》.北京:中国中医药出版社,1994,5:183
    [10] 清·雷丰.《时病论·暑风》.北京:人民卫生出版社,1978,3:58
    [11] 清·雷丰.《时病论》.北京:人民卫生出版社,1978,3:56-59
    [12] 赵嘉俊.脑血管发病率与气候背景的逐步回归分析[J].天气气象,1993,(4):29—31
    [13] 刘寅,付乃宽,梁爽霖,等.天津地区急性心肌梗死发病与气象因素关系的探讨[J].中国介入心脏病学杂志,1995,3(4):184
    [14] 谈建国,瞿惠春.猝死与气象条件的关系[J].气象科技,2003,31(1):58—61
    [15] 林丁茂.268例心、脑血管疾病发病与季节、气象关系分析[J].福建医药杂志,1994,16(1):17—18
    [16] 张嘉余.脑出血的发病与气象变化的关系[J].江苏医药,1994, 20(5):257
    [17] 蒋晓宜.脑卒中发病与气象关系的探讨[J].上海预防医学杂志,1994,6(9):29—31
    [18] 李相猛,黄科.脑卒中疾病发生的气象条件分析及对其发病人数的预测[J].广东气象,2002,(2):44—46
    [19] 王维桐.沈阳市脑卒中发病与气候关系的分析[J].辽宁气象,1991,(1):45—47
    [20] 王艳萍,等.气象因素对人体支气管发病影响的探讨[J].辽宁气象,1992,(4):29—30
    [21] 何飞.空气湿度对人体健康的影响[J].广西气象,1992,(1):29—3
    [22] 金·刘完素.《素问玄机原病式》载《金元四大家医学全书(上)》.天津:天津科学技术 出版社,1999,6:33
    [23] 宋广舜.环境医学[M].天津:天津科学技术出版社,1987
    [24] 加地正郎.呼吸系统感染与气象、季节[J].日本医学介绍,1986,7(1):12
    [25] 清·雷丰.《时病论·霉湿》.北京:人民卫生出版社,1978,3:63
    [26] 袁长焕.天气诱发疾病[J].健康文摘,1999,(6):39
    [27] 乔梁,冯德勋.急性心肌梗死发病与季节气候及昼夜变化的关系[J].湖北中医学院学报,2000,2(1):24—25
    [28] 广州市心血管研究协作组.广州市急性心肌梗死发病与气象因子的分析[J].中华内科杂志,1984,23(9):548—551
    [29] M. L. Nicodemus, W. T. Hodge, L. J. Weiner. Life of Climate. The Eneyclo-pedia of Climatology. American: Lewis Publishers, 1980
    [30] 郑有飞,钱晶.紫外辐射增加人类影响[J].气象科学,1999,(2):15—16
    [31] 唐·孙思邈.《千金翼方卷第十一·小儿》.北京:中国中医药出版社出版,1998,12:636
    [32] 王鼎.气象与精神分裂关系的研究[J].内蒙古气象,1994,(4):39—41
    [33] 陈耀金.气候因素与精神分裂症流行病学关系探讨[J].右江民族医学院学报,1999,(4):565—567
    [34] 陈和.福州市流脑与气象及预报[J].福建气象,1989,(4):20—25
    [35] 明·吴有性.《瘟疫论卷上·原病》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:9
    [36] 明·吴有性.《温疫论补遗·伤寒例正误》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:43
    [37] 南京中医学院伤寒教研组编著.伤寒论译释·伤寒例第三[M].上海:上海科学技术出版社,1980,10:277
    [38] 清·雷丰.《时病论·夏伤于暑大意》.北京:人民卫生出版社,1978,3:56
    [39] 明·吴有性.《温疫论补遗·伤寒例正误》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:43
    [40] 清·杨璿.《伤寒瘟疫条辨·温病与伤寒治法辨》[M].北京:人民卫生出版社,1986,9:19
    [41] 元·李杲.《脾胃论》.沈阳:辽宁科学技术出版社,1997,8
    [42] 金·刘完素.《伤寒直格论方·序》载《金元四大家医学全书(上)》.天津:天津科学技术出版社,1999,6:244
    [43] 金·刘完素.《素问玄机原病式》载《金元四大家医学全书(上)》.天津:天津科学技术出版社,1999,6:31,22
    [44] 金·刘完素.《黄帝素问宣明论方》载《金元四大家医学全书(上)》.天津:天津科学技术出版社,1999,6:66,66,77,66
    [45] 隋·巢元方.《诸病源候论·时气病诸候》.北京:人民卫生出版社影印本,1982:五三
    [46] 晋·葛洪.《肘后备急方·治伤寒时气温病方第十三》载《中华医书集成(八):方书类一》.北京:中医古籍出版社,22
    [47] 隋·巢元方.《诸病源候论·疫疠病候》.北京:人民卫生出版社影印本,1982:六四
    [48] 清·杨璿.《伤寒瘟疫条辨·行邪伏邪辨》[M].北京:人民卫生出版社,1986,9:22
    [49] 明·吴有性.《温疫论·引》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:5
    [50] 明·吴有性.《温疫论·原病》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:9
    [51] 明·吴有性.《温疫论·杂气论》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:26
    [52] 清·杨璿.《伤寒瘟疫条辨·温病与伤寒根源辨》[M].北京:人民卫生出版社,1986,9:19
    [53] 清·杨璿.《伤寒瘟疫条辨·杂气有盛衰辨》[M].北京:人民卫生出版社,1986,9:38
    [54] 清·王士雄.《随息居重订霍乱论·热证》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:654
    [55] 清·雷丰.《时病论·秽浊》.北京:人民卫生出版社,1978,3:61
    [56] Henry GJ, William SL, Shery LT, et al. Anti-inflammatory and lung function effects of montelukast in asthmatic volunteers exposed to rulfurdioxide[J]. Chest, 2001, 119:402-408
    [57] Min YG, Kim JW, Hong SC, et al. Pathogenetic Mechanism of Olfactory Cell Injury after Exposure to Sulfur Dioxide in Micel [J]. Laryngoscope, 2003, 113: 2157-2162
    [58] Gunnison AF. Sulphite toxicity: a critical review of in vitro and in vivo data[J]. Food Cosmet Toxicol, 1981, 19: 667-682
    [59] Gokirmak M, Yildirim Z, Canan HH, et al. The role of oxidative stress in bronchoconstriction due to occupational sulfur dioxide exposure [J]. ClinChim Acta, 2003, 331: 119-126
    [60] Fodok VA, Cathelineau A, Daleke DL, et al. Loss of phospholipid asymmetry and surface exposure of phosphatidylserine is required for phagocytosis of apoptotic cells by macrophages and fibroblasts[J]. Biol—Chem, 2001, 276:1071
    [61] Pelletier M, Lavastre V, Girard D. Activation of human epithelial lung A549 cells by the pollutant sodium sulfite: enhancement of neutrophil adhesion[J]. Toxical Sci, 2002, 69:210-216
    [62] Englert N. Fine particles and human health—a review of epidemiological studies[J]. Toxicology Letters, 2004, 149(1-3): 235-242
    [63] Mueller-Anneling L, Avol E, Peters JM, et al. Ambient endotoxin concentrations in PM10 from Southern California. Environmental Health Perspectives[J]. 2004, 112(5): 583-588
    [64] Joachim Heinirich, Mike Pitz, Wolfgang Bischof, et al. Endotoxin in fine(PM2. 5)and coarse (PM10-2.5)particle mass of ambient aerosols. A temporospatial analysis[J]. Atmospheric Environment 2003, 37, 3659-3667
    [65] Purdy C W, Straus DC, Parker DB, et al. Comparison of the type and number of microorganisms and concentration of endotoxin in the air of feed yards in the Southern High Plains[J]. American Journal of Veterinary Research. 2004, 65(1): 45-52
    [66] Von Essen S, Romberger D. The respiratory inflammatory response to the swine confinement building environment: the adaptation to respiratory exposures in the chronically exposed worker[J]. Journal of Agricultural Safety & Health, 2003, 9(3): 185-196
    [67] Roy CJ. Thorne PS. Exposure to particulates, microorganisms, beta(1-3)-glucans, and endotoxins during soybean harvesting[J]. AIHA Journal: a Journal for the Science of Occupational & Environmental Health & Safety. 2003, 64(4): 487-495
    [68] Madsen AM. Martensson L, Schneider T, et al. Microbial dustiness and particle release of different biofuels[J]. Journal of Allergy & Clinical Immunology, 2004, 48(4): 327-338
    [69] 曹强,宋伟民,张澍,等.大鼠慢性支气管炎模型在颗粒物PM2.5毒性研究中的应用.环境污染对健康的影响—“环境污染与健康”国际研讨会论文集,2005,11,282—287
    [70] Sawyer WD, Jemski JV, Hogge AL Jr, et al. Effect of aerosol age on the infectivity of airborne Pasteurella Tulare sis for macaca mulatta and man. J bact, 1966, 91(6): 2180~2184
    [71] 曹炳章原辑.《中国医学大成·湿温时疫治疗法·传染》[M].北京:中国中医药出版社,1997,10:424
    [72] 隋·巢元方.《诸病源候论·食注候》.北京:人民卫生出版社影印本,1982:一三三
    [73] 唐·孙思邈.《备急千金要方卷第二十·膀胱腑·霍乱第六》.北京:中国中医药出版社出版,1998,12:336
    [74] 车凤翔主编.空气生物学原理及应用[M].北京:科学出版社,2004,149
    [75] 明·虞抟.《医学正传》.北京:人民卫生出版社,1981,12:161
    [76] 明·张介宾.《景岳全书·杂证谟》.北京:中国中医药出版社,1994,5:160
    [77] 清·陈耕道.《疫痧草》.北京:中国中医药出版社,2000,12:三一四
    [78] 孙仲毅,张晨霞.气候与人类皮肤健康[J].河南气象,1996,3:37—38
    [79] 隋·巢元方.《诸病源候论·蛊毒诸病候·沙虱候》.北京:人民卫生出版社影印本,1982:一三七
    [80] 宋·王怀隐等编.《太平圣惠方》.北京:人民卫生出版社 1982,2:2125
    [81] 清·喻嘉言.《喻嘉言医学全书·寓意草·辨黄鸿轩臂生痈疖之证并治验》.北京:中国中医药社,2003,1:429
    [82] 清·高秉钧.《疡科心得集·疡证总论》载《中华医书集成(十四):外科类二》北京:中医古籍出版社,
    [1] 元·李杲.《脾胃论·天地阴阳生杀之理在升降浮沉之间论》.沈阳:辽宁科学技术出版社,1997,22
    [2] 高志勤,余海鹰,白战生,等.1993年中国七个地区精神分裂症流行病学调查资料的气候因素再分析[J].中华精神科杂志,2003,36(J):56
    [3] 清·唐宗海.《血证论·时复》卷六.见张崇泉《中华医书集成》第十二册.北京:中医古籍出版社,71
    [4] 刘达云,孙丽玲,肖开银.854例溃疡病出血与月亮盈亏变化关系[J].广西中医药1995,18(5):11—13
    [5] 胡剑北编著.中医时间医学[M].合肥:安徽科技出版社,1990,59
    [6] 李浚川,李湘云.情志医学[M].北京:中医古籍出版社,1994,56—57
    [7] 孙庆伟,李东亮.人体生理学[M].北京:中国医药科技出版社,1994,106—176
    [8] 夏桂成.概述二十四节与妇女病及其辨治的关系[J].南京中医药大学学报,2005,21(1):5—7
    [9] 金·张从正.《儒门事亲》载《中国医学大成(九):医论分册》[M].北京:中国中医药出版社,1997,10:376
    [10] 清·雷丰.《时病论·春伤于风大意》.北京:人民卫生出版社,1978,3:18
    [11] 清·雷丰.《时病论·秋伤于湿大意》.北京:人民卫生出版社,1978,3:104
    [12] 明·吴有性.《温疫论·诸家温疫正误》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:45
    [13] 清·何梦瑶.《医碥·卷六》载《中华医书集成(三十):综合类9》.北京:中医古籍出版社,204
    [14] 吕书勤,凌昌全.浅析肝癌与“湿[J].天津中医药,2004,21(2):134—136
    [15] 李再刚,姚应琴,熊紫云.消化性溃疡疾病与气象环境关系探讨[J].陕西气象,2002(4):15-17
    [16] 陈观进,陈立军,倪少凯.湛江地区消化性溃疡检出率与气象因素关系的探讨[J].现代预防医学,1998,25(1):36—38
    [17] 汪寿鹏.季节性气候变化对病毒性肝炎发病证型及ALT指标的影响[J].湖北中医杂志,2002,24(3):9—10
    [18] 姚泰主编.人体生理学[M].北京:人民卫生出版社,2001,12:1813
    [19] 清·吴瑭.《温病条辨》.北京:人民卫生出版社,1979,7:12,15
    [20] 明·吴有性.《温疫论补遗·伤寒例正误》载《中国医学大成(四):温病分册》.北京: 中国中医药出版社,1997,10:43
    [21] 清·吴坤安.《伤寒指掌·风温》.上海:上海卫生出版社,1957,3:234
    [22] 清·雷丰.《时病论》.北京:人民卫生出版社,1978,3:104,108,109
    [23] 姚咏明.杀菌/通透性增强蛋白对休克大鼠肺组织细胞因子mRNA表达的影响[J].中华外科杂志,1997,35(7):389
    [24] Rennekamp-OH. Effects of recombinant bactericidal, permeability-increasing protein on bacterial translocation and pulmonary, neutrophil sequestration in burned mice [J]. H-Burn-Care-Rehabil.1997, 18(1pt1):17
    [25] 吴智兵,彭胜权.湿热环境在湿温发病中的作用机理探讨[J].上海中医药杂志,2003,37(12):45—46
    [26] 清·郑寿全.《医理真传·阴虚证问答》.北京:中国中医药出版社,1993,74
    [27] 明·虞抟.《医学正传·疟证》载《中华医书集成(二十五):综合类4》北京:中医古籍出版社,77
    [28] 于长水,张之化,丛波泉.全球变暖与传染病动向[J].中华流行病学杂志,1998,19:114—117
    [29] 王占东,主编.法定传染病的预防与控制[M].沈阳:辽宁大学出版社,1999,32—33
    [30] 张岚.细菌性痢疾季节性高峰变化及其与气温关系的研究[J].中国自然医学杂志,2002,4(3):145—146
    [31] 丁元庆.火热病邪在脑病发病中的致病作用及证治[J].中国中医基础医学杂志,2001,7(1):44—45
    [32] 熊露,田少霞,范吉平,张学文.刍议从络、水、瘀、毒辨证缺血性中风[J],中国中医急症,2004,13(12):835—838
    [33] 郑锐锋,李春生,王小沙,等.病毒性心肌炎病因病机的探讨[J].中国中医急症,2004,13(9):599—600
    [34] 陈茂刚.试论病毒性心肌炎属于“温病”范畴[J].时珍国医国药,2002,13(5):295—297
    [35] 石蕴玉,张镜人.治疗病毒性心肌炎的经验[J].浙江中医杂志,1996,31(6):42
    [36] 何建成.病毒性心肌炎中医药治疗的再思考[J].中医药研究,1999,15(1):53
    [37] 田淑芳.刘弼臣治疗小儿病毒性心肌炎的经验[J].河北中医,1994,16(6):13
    [38] 王鹂,魏陵博,刘学法,等.热毒学说在急性冠脉综合征中的地位[J].中西医结合心脑血管病杂志,2005,3(12):1080—1081
    [39] 丁书文,李晓,李运伦,等.热毒学说在心系疾病中的构建与应用[J].山东中医药大学学报,2004,28(6):413—416
    [40] Roberton CA, Vyse TJ. The genetics of systemic lupus erythematosus. Exp Nephrol, 2000, 8: 194-202
    [41] 黄彩平,韦大文.伏邪说在感染性疾病治疗中的意义[J].河南中医,2001,21(6):15—16
    [42] 曾昭华,曾雪萍.鼻咽癌与环境关系的探讨[J].广西科学,1999,6(1):56
    [43] 曾昭华,蔡伟娣,曾雪萍.江西省宫颈癌与气象要素[J].江西科学,1996,14(3):156—160
    [44] 宛无为.癌症和爱滋病的气象致病因素[J].中国保健营养,2003,(3):38
    [45] 李雄,郭琳芳,董蕙青.癌症死亡的气象影响因素探讨[J].气象科技,2005,33(6):577—579
    [46] 周岱翰.温病学说在恶性肿瘤论治中的应用与展望[J].上海中医药杂志 2004,38(4):7—9
    [47] 吴沈春.环境与健康[M].北京:人民卫生出版社,1982,230
    [48] Omran, AR. The epidemiologic transition: A theory of the epidemiology of population change.Mil-bank Memorial Fund Quarterly, 1971, 49:509-538
    [49] 南朝宋·范晔.《后汉书卷五十四·马援列传第十四》.郑州:中州古籍出版社:1996,10:311
    [50] 郭霭春.中国医史年表[M].哈尔滨:黑龙江人民出版社,1984,12:10
    [51] 郭霭春.中国医史年表[M].哈尔滨:黑龙江人民出版社,1984,12:19
    [52] 明·宋濂.《元史·武宗纪》卷22.北京:中华书局,1976,502
    [53] 井村哮全.地方志所载之中国疫疠考.中外医事新报,1936,1233号
    [54] 清·李炳.《辨疫琐言》.见裘吉生《珍本医书集成》第七册.上海:世界书局,1935,8
    [55] 清·张廷玉.《明史·神宗纪》卷十二.北京:中华书局,1974,272
    [56] 清·赵尔巽.《清史稿·朱休度传》卷四百七十七.北京:中华书局,1977,13031
    [57] 马端临.《文献通考·物异》卷三百四.考二三九六.上海:商务印书馆,1937
    [58] 李培浩.《中国通史讲稿》.北京:北京大学出版社,1982,170
    [59] 明·吴有性.《重订医门普度温疫论·林起龙论疫》载《中国医学大成(四):温病分册》[M].北京:中国中医药出版社,1997,10:102
    [60] 马端临.《文献通考·物异》卷三百四.考二三九六.上海:商务印书馆,1937
    [61] Moore Ede MC. Physiology of the circadian timing system: predictive versus reactive homeostasis. Am J Physiol, 1986, 250:735

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