| 楼毅杰,吴夏俊,崔宇胜,等.“除邪务尽”与“除邪勿尽”观点对外感热病恢复期辨治的启示[J].浙江中医药大学学报,2020,44(11):1035-1041. |
| “除邪务尽”与“除邪勿尽”观点对外感热病恢复期辨治的启示 |
| Enlightenment of the View of “Eliminating and Exhausting Pathogens” and “Eliminating But Not Exhausting Pathogens” on the Differentiation and Treatment of Exogenous Fever in Recovery Period |
| DOI：10.16466/j.issn1005-5509.2020.11.002 |
| 中文关键词: 除邪务尽 除邪勿尽 外感热病 恢复期 新型冠状病毒肺炎 伏邪 |
| 英文关键词: eliminating and exhausting pathogens eliminating but not exhausting pathogens exogenous fever recovery period COVID-19 hidden evil |
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| 中文摘要: |
| [目的]梳理并分析“除邪务尽”与“除邪勿尽”观点的形成与内涵，探讨其对外感热病恢复期辨治的启示。[方法]梳理并分析《黄帝内经》至明清时期“除邪务尽”与“除邪勿尽”观点的形成，对比“除邪务尽”与“除邪勿尽”观点的异同，并以此次新型冠状病毒肺炎(以下简称新冠肺炎)恢复期为例，基于“除邪务尽”与“除邪勿尽”的观点，结合各版新冠肺炎恢复期的辨治方案，探索外感热病恢复期的中医辨治思路。[结果]“除邪务尽”观点认为对于外感邪气必须完全祛除，以免伏留人体，变生他疾，在治法上应遵循“祛邪外出”-“调畅枢机”-“补养正气”的治疗次第，多采用发汗、泻下、清宣之法，用药上多选用清解、宣透、调畅气机之药，慎用温补味厚之品，以免碍邪外出、耗伤阴液。“除邪勿尽”主要针对内滞入里的邪气，多适用于年事已高、素体亏虚、病程已久的内伤之人，其治疗重心由“逐邪”向保全人之生机、激发鼓舞正气、保持五脏安和转变，多选疏解、调中再予补益或清滋、培补激发正气的法度。[结论]外感病恢复期辨治中对于外邪、伏邪当参照“除邪务尽”的原则，以防复证；对于外邪祛除后残留体内的痰瘀湿浊，可按照“除邪勿尽”观点，视人体表证存留情况、阳气亏耗程度、体质强弱，治疗因人而异。恢复期患者应注意饮食起居，注意调摄，以免因起居不当出现复证。 |
| 英文摘要: |
| [Objective]To sort out and analyze the formation and connotation of the viewpoints of “eliminating and exhausting pathogens”and “eliminating but not exhausting pathogens”， as well as the enlightenment to the differentiation and treatment of exogenous fever in recovery period. [Methods]Through combing and analyzing the formation of the views of “eliminating and exhausting pathogens”and “eliminating but not exhausting pathogens” from “Inner Canon of the Yellow Emperor” to Ming and Qing Dynasties，the similarities and differences between“eliminating and exhausting pathogens” and “eliminating but not exhausting pathogens” were compared. Taking the recovery period of the Corona Virus Disease 2019(COVID-19) as an example， through various versions of the COVID-19 in the recovery period of the differential treatment plan， combining with the “eliminating and exhausting pathogens” and “eliminating but not exhausting pathogens” views， the traditional Chinese medicine treatment ideas of the exogenous fever in the recovery period were explored.[Results] According to the viewpoint of “eliminating and exhausting pathogens”， the exogenous pathogens must be completely eliminated， so as to prevent it from staying in the human body and causing other diseases. The treatment should follow the treatment order of “expelling pathogens and going out”-“regulating pivot”-“nourishing and invigorating healthy Qi”， and the methods of sweating， purgation and clearance and distribution should be adopted. The medicine should be used to clear away， penetrate and regulate Qi activity， and warm and tonic herbs should be used carefully so as not to prevent evil from going out and consuming Yin fluid. “Eliminating but not exhausting pathogens” is mainly aimed at the evil Qi that stagnates into the interior. It is mostly applied to the elderly， deficiency of the body and long-term course of internal injury. The focus of treatment should be changed from “expelling evils” to preserving people's vitality， stimulating and encouraging the healthy Qi， and maintaining the harmony of five viscera， and choosing the methods of soothing， regulating and then tonifying， clearing and nourishing， and stimulating healthy Qi. [Conclusion] During the recovery period of exogenous diseases， treatment should follow the principle of “eliminating and exhausting pathogens”to prevent the recurrence of syndromes. For the residual phlegm， blood stasis， dampness and turbidity in the body after the elimination of external pathogenic factors， the treatment should be based on the view of “eliminating pathogens but not exhausting pathogens”， depending on the retention of exterior syndromes， the degree of Yang Qi depletion and the strength of constitution vary from person to person. At the same time， patients in recovery period should pay attention to diet， living， and adjusting intake， so as to avoid recurrence syndrome due to improper living. |
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