[关键词]
[摘要]
中医临床医家何炎燊提出以疗效为先,不可拘泥于伤寒与温病的既定理论和方药,而需根据具体情况,从病因、病 性、患者体质及生活方式等多因素综合辨证,灵活将伤寒与温病的理法方药进行融合(简称“寒温融合”)用来指导个体化的 辨证论治。何炎燊之寒温融合理论指导临床辨治实践的具体表现如下:论治登革热,以辨证为基础,博采众方,将辛温解 表与辛凉撤热两法合用,寒温并用,以迅速控制病势,缩短病程;不盲从前人之“柴胡劫肝阴”论,常用柴胡治疗热病; 针对伤寒之下法不宜过早及温病之不可下观点,及时使用下法,可使偏盛偏衰的阴阳趋向平衡,使逆乱乖戾的气机循于常 度;治病务求平调阴阳,顾护津液。何炎燊经典内科流派的第二代代表性传承人刘石坚教授与第三代代表性传承人王文辉 教授传承并发展了寒温融合理论。何炎燊之寒温融合理论可为中医外感热病及内伤杂病的治疗提供新的思路和方法。
[Key word]
[Abstract]
He Yanshen,a clinical practitioner of traditional Chinese medicine (TCM),advocated prioritizing therapeutic efficacy over rigid adherence to the classical theories and formulas for cold-induced disease and warm disease. He proposed that a comprehensive syndrome differentiation should be performed under the specific circumstances,including the etiology and nature of diseases,and the constitution and lifestyle of patients,and then he established an approach of cold-warm integration. This approach flexibly integrates the classical principles, methods, formulas, and medicinals for cold-induced disease and warm disease, and helps to guide individualized syndrome differentiation and treatment. The clinical practice of He Yanshen’s cold-warm integration theory is manifested as follows:for the treatment of dengue fever,emphasis is placed on syndrome differentiation, and cold-warm integration is embodied by the utilization of both acrid-warm exterior-releasing method and acridcool heat-clearing method after extensively searching from various classical formulas,so as to rapidly control the progression of the disease and shorten its course;He Yanshen did not blindly follow the historical admonition that Bupleuri Radix consume liver yin, and frequently used it for the treatment of febrile diseases; regarding the viewpoint that purgation should not be allowed to apply too early for cold-induced disease and purgation is contraindicated for warm disease, He Yanshen advocated that timely use of the purgative method will help rebalance the hyperactive or deficient yin-yang state and normalize the disturbed and rebellious qi movement;the key to treat the disease is to gently regulate yin and yang and protect body fluids. Professor Liu Shijian,the second-generation representative inheritor of the He Yanshen Classical Internal Medicine School, and Professor Wang Wenhui,the third-generation representative,have both inherited and further developed the theory of cold-warm integration. He Yanshen’s cold-warm integration theory provides new perspectives and methods for the treatment of exogenous febrile diseases and endogenous miscellaneous diseases in traditional Chinese medicine.
[中图分类号]
R259
[基金项目]
国家中医药管理局“刘石坚全国名老中医药专家传承工作室”建设项目(国中医药人教函 〔2019〕 41 号);“王文辉东莞市名中 医药专家传承工作室”建设项目(东卫函 〔2021〕134 号)