文章摘要
龙超君,白辰,刘邵阳,等.温病卫分证辨析及临床应用[J].浙江中医药大学学报,2021,(1):34-37.
温病卫分证辨析及临床应用
Discrimination and Clinical Application of Febrile Disease's Wei-phase Syndrome
投稿时间:2020-04-29  
DOI:10.16466/j.issn1005-5509.2021.01.006
中文关键词: 卫分证  表证  银翘散  温病  卫气营血辨证  临床应用
英文关键词: Wei-phase syndrome  exterior syndrome  Yinqiao powder  febrile disease  differentiation of defense, Qi, nutrient and blood aspects  clinical treatment
基金项目:国家自然科学基金项目(81973724);北京市科技专项(Z181100006218083)
作者单位E-mail
龙超君 北京中医药大学 北京 100029  
白辰 北京中医药大学 北京 100029  
刘邵阳 北京中医药大学 北京 100029  
胡莉 北京中医药大学 北京 100029  
于河 北京中医药大学 北京 100029  
刘铁钢 北京中医药大学 北京 100029 liutiegang2009@163.com 
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中文摘要:
      [目的]辨析温病卫分证的病变实质,以减少其失治误治,更好地发挥其临床应用价值。[方法]从病因、病位、病机、病变阶段等方面对温病卫分证进行阐释,辨析卫分证与表证的关系,总结卫分证的治则治法及代表性药物,并结合医案阐述卫分证的临床应用要点。[结果]从病因上说,温病卫分证多由风热病邪、燥热病邪引起;从病位上说,卫分证的主要病变部位在肺卫;从病机上说,卫分证的病机为热邪郁滞、肺卫失宣,核心病理特点是热和郁;从病变阶段上说,卫分证与气分证之间的界限并不明确,但治则大不相同;从卫分证与表证的关系上说,卫分证属于广义表证,不同于狭义伤寒表证,但二者具有一定共性;从治法治则上说,卫分证重在宣散、透热,兼顾养阴;从临床应用要点上说,文中收录了一则因风热初袭、肺卫失宣而致的小儿发热案,治以辛凉宣透,方用银翘散加减,提示卫分证在治疗上宜以宣透肺卫郁热为主,用药选用轻清宣透之品,用量需小,煎煮时间宜短,少量频服为佳。[结论]卫分证的病因、病位、病机、病变阶段有鲜明特点,这决定了卫分证的治疗原则和遣方用药具有相应的特色,应充分挖掘卫分证的病变实质,掌握临床应用要点,减少失治误治。
英文摘要:
      [Objective]To distinguish the pathological essence of febrile disease's Wei-phase syndrome, so as to reduce its mistreatment and give full play to its clinical application value.[Methods] Through investigating the etiology, location, pathogenesis and pathological stage of Wei-phase syndrome, the relationship between Wei-phase syndrome and exterior syndrome was analyzed, while the therapeutic principle along with the representative herbs was summarized. Besides,the treatment points of Wei-phase syndrome were concluded and reflected in a medical case.[Results] In terms of etiology, the Wei-phase syndrome is mostly caused by wind-heat and dry-heat. In terms of disease location, the pulmonary system is the main affected area of Wei-phase syndrome. In terms of pathogenesis, the pathogenesis of Wei-phase is stagnation of heat pathogen and abnormal cohesion of defensive Qi of the lung, and the core pathological characteristics are heat and depression. From the stage of disease, the boundary between Wei-phase syndrome and Qi-phase syndrome is not clear, but the treatment of the two is quite different. From the the relationship between Wei-phase syndrome and exterior syndrome, Wei-phase syndrome belongs to the generalized exterior syndrome, whose treatment is completely different from the treatment of the narrowly-defined exterior syndrome, but there are commonalities between the two. In terms of the therapeutic principles, treating Wei-phase syndrome should focus on vaporizing the stagnated heat and giving consideration to nourishing Yin if necessary.From the key points of clinical application, a medical record was included in this article, which was a case of fever in child caused by the invasion of wind-heat, and stagnation of defensive Qi, so the pungent-cold medicines were applied and modified Yinqiao powder was the main prescription. It is suggested that the treatment of Wei-phase syndrome should be based on dredging the stagnation of heat and depression in pulmonary system. The medication should be light, the dosage should be small, the decoction time should be short, and a small amount of frequent medication is better. [Conclusion] The febrile disease's Wei-phase syndrome has its special characteristic in etiology, location, pathogenesis and pathological stage, which determines that the treatment principle of Wei-phase syndrome and its prescription have corresponding characteristics. It is necessary to fully understand the essence of the Wei-phase syndrome and grasp the main points of clinical application to reduce mistreatment.
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