摘要
历代医家对湿温、湿热的概念出处和认知等存在较大争议,这使得时人及后人对二者的差异混淆不清,从而影响临证。该研究通过辨析湿温和湿热的概念出处及其内涵演变,探讨二者的区别和联系。结果显示,金元时期的医家们认为“湿热”多为内伤杂病,“湿温”则多为外感热病;从病因来看,二者皆是湿热为患。明清之后的医家将二者的区别逐渐淡化,湿温被统一在湿热中,统称为“外感湿热证”。历代医家对湿温与湿热的认知过程,经历了从病因或病机到病证名的变迁。湿温与湿热内涵的演变拓展了中医对疾病病因、病机、病证的认识。通过辨析“湿温”与“湿热”,可明确疾病的病因与病证发展,从而正确指导用药及判断预后。
Great controversy exists in the origin and perception of damp-warm and damp-heat among medical practitioners throughout the ages,which has led to the confusion of the present and later generations about their differences and has an influence on their clinical practice. This study explores the differences and connections between the concepts of damp-warm and damp-heat by identifying their origins and analyzing the evolution of their connotations. The results showed that medical practitioners of the Jin and Yuan dynasties considered“damp-heat”mostly as endogenous miscellaneous diseases, while considered“damp-warm”mostly as exogenous febrile diseases. From the perspective of etiology,both damp-warm and damp-heat are caused by damp-heat pathogen.After the Ming and Qing dynasties,the distinction between the two faded gradually and then was unified under the category of damp-heat, collectively referred to as“exogenous damp-heat syndrome”. The cognitive process between damp-heat and damp-warm has changed over the ages,and experienced the evolution from the etiology or pathogenesis to the syndrome. The evolution of the connotations of damp-warm and damp-heat has expanded the range of the etiology, pathogenesis and disease-syndrome in the field of traditional Chinese medicine. By distinguishing between“damp-warm”and“damp-heat”, the etiology and development of the disease can be clarified,and the use of medicine and the judgement of prognosis can be made exactly.
作者
宁百乐
邓启粤
纪雪梅
周登威
NING Bai-Le;DENG Qi-Yue;JI Xue-Mei;ZHOU Deng-Wei(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China;Tianjin Binhai New Area Hospital of Chinese Medical Sciences,Tianjin 300450,China;Postdoctoral Research Station,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《广州中医药大学学报》
CAS
2023年第1期220-223,共4页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家自然科学基金项目(编号:81774411,82074522,81804166)
广东省自然科学基金项目(编号:2019A1515012043,2018A030310531)
广东省重点领域研发计划——岭南中医药现代化重点专项(编号:2020B1111100007)
广州市科技计划项目(编号:202102010247)
广东省中医药局科研项目(编号:20201146)
广东省中医院拔尖人才科研专项(编号:BJ2022KY10)
广东省中医药科学院资助项目(编号:YN2019ML13)
广州中医药大学“双一流”与高水平大学学科协同创新团队项目(编号:2021xk22)。
关键词
湿温
湿热
外感热病
内伤杂病
病因
病机
病证
damp-warm
damp-heat
exogenous febrile diseases
endogenous miscellaneous diseases
etiology
pathogenesis
disease-syndrome
