《伤寒论》是中医辨治疫病的奠基之作（一）.docxVIP

· 1 ·第 39 卷第 6 期 Vol. 39 No. 6 · 1 · 2023 年 6 月 HUNAN JOURNAL OF TRADITIONAL CHINESE MEDICINE Jun. 2023 ●抚今追古话疫病● 引用 :袁长津.《 伤寒论》是中医辨治疫病的奠基之作( 一 ) [J] . 湖南中医杂志 ,2023 ,39(6) :1-9. 《 伤寒论》是中医辨治疫病的奠基之作( 一) 袁长津 ( 湖南中医药大学第二附属医院 ,湖南 长沙 ,410005) [ 摘要] 东汉张仲景所著《 伤寒杂病论》一 书中 , 虽没有后世疫病之名目 ,却真实记载了大量辨治疫病 之证治方药的条文及案例经验 。笔者抚今追古 ,重温经典 ,结合自己多年的临床经验及其体认 ,并引证了当 代诸多医家名宿之论 ,认为《 伤寒论》堪称我国古代疫病防治的奠基之作 。《 伤寒论》虽以辨治寒疫及寒湿疫 为主 ,但也包括湿热类、热毒类及瘀毒类疫病的证治 。其所论及疫病的类型及疑似病种 ,寒湿类疫病主要包 括 :流行性感冒及其并发呼吸道和消化道感染 ,流行性脑脊髓膜炎 ,流行性腹泻( 寒性) 及寒性霍乱 ,流行性 出血热等急性传染病;温热类疫病最为确定的是“黄疸”和“ 下利”,其证候与现代所谓急性病毒肝炎和急性 细菌性痢疾基本相同;该书还开示了辨治热毒疫、瘀毒疫之法门 ,对后世影响深远 。笔者还从《 伤寒论》全篇 整体分析 ,体悟到张仲景以“正邪博弈”为核心理念辨治外感疫病的思想 ,分别采取以祛邪为主、以扶正为主 或以祛邪扶正并重的治则大法;并开创了病证结合、以辨证论治为主的中医诊疗模式。 [ 关键词] 疫病 ;寒湿疫 ;温热疫 ;瘀毒疫 ;《伤寒论》;奠基之作 [ 中图分类号] R259. 11 [ 文献标识码] A DOI :10. 16808/j. cnki. issn1003-7705. 2023. 06. 001 Treatise on Febrile and Miscellaneous Diseases is the foundation work of traditional Chinese medicine diagnosing and treating epidemiology ( Ⅰ) YUAN Changjin (The Second Affiliated Hospital of Hunan University of Chinese Medicine , Changsha 410005 , Hunan , China ) [ Abstract] In the book of Treatise on Febrile and Miscellaneous Diseases written by Zhang Zhongjing in the Eastern Han Dynasty , although there are no names of epidemic diseases in later generations , it truly records a large number of items and case experience in the syndrome differentiation -based treatment of epidemic diseases. With reference to his own clinical experience and understanding for many years , the author focuses on the present , revis- its the classics , cites the theories of many famous contemporary doctors , and believes that Treatise on Febrile and Miscellaneous Diseases can be regarded as the foundation for the prevention and treatment of ancient epidemic dis- eases in China. Although Treatise on Febrile and Miscellaneous Diseases mainly describes the syndrome differentia- tion-based