从热-痰-瘀-虚病机演进探析外感热病截断扭转策略OA
Exploring the Interception-Reversal Strategy for Exogenous Febrile Diseases:Based on the Progression from Heat to Phlegm,Stasis,and Deficiency
外感热病起病急骤,传变迅速,临床治疗需主动出击,阻其深入.截断扭转策略强调预见性辨证与积极性治疗,通过早期、有力的干预,以截断病因,扭转病势,从而打破疾病的传变进程.本文基于截断扭转理论,系统梳理外感热病以热、痰、瘀、虚为核心环节的病机演进规律:初期热邪炽盛,灼伤阴液;继则热炼津血,痰瘀互结;进而痰瘀生变,动风闭窍;终期正虚邪恋,缠绵难愈.针对此病机链,构建阶梯式干预策略:祛邪护阴以遏制传变,痰瘀同治以化解胶结,搜络息风以防控变证,扶正透邪以断缠绵,实现从见症截断向据机先断的理念提升,为外感热病临床防治提供贯穿全程的辨治体系.
Exogenous febrile diseases are characterized by sudden onset and rapid transmission,necessitating proactive interven-tion to prevent further progression.The intercepting and reversing strategy emphasizes predictive diagnosis and proactive treatment,aiming to interrupt the causative factors and reverse the disease trajectory through early and potent measures,thereby breaking the chain of disease transmission.Based on this theory,this article systematically reviews the pathogenetic evolution of exogenous febrile diseases centered on the sequential interplay of heat,phlegm,stasis,and deficiency.In the initial stage,intense heat consumes body fluids;subsequently,heat congeals fluids and blood,leading to the interlocking of phlegm and stasis;then phlegm and stasis generate further pathological changes,stirring wind and blocking the orifices;in the terminal stage,healthy qi is depleted while pathogenic fac-tors linger,resulting in protracted and recurrent illness.In response to this pathogenetic chain,a stepwise intervention strategy is pro-posed:expelling pathogens and protecting yin to block transmission,simultaneously resolving phlegm and stasis to dissolve their cohe-sion,dredging collaterals and calming wind to prevent complications,and reinforcing healthy qi while dispelling pathogens to eliminate residual evils.This multilayer,interlocking approach elevates the therapeutic paradigm from"intercepting based on manifest symp-toms"to"preemptive interception based on pathogenetic mechanisms",providing an integrated pattern differentiation and treatment system for the clinical management of exogenous febrile diseases throughout their entire course.
严怡婷;殷籽晗;刘仲书;朱平;张彦亮;杨进;瞿旻晔;魏凯峰
南京中医药大学中医学院,江苏 南京 210023南京中医药大学中医学院,江苏 南京 210023蒙自市中医医院内一科,云南 蒙自 6611002南京中医药大学中医学院,江苏 南京 210023||南京中医药大学附属南京中医院,江苏 南京 210022南京中医药大学附属南京中医院,江苏 南京 210022南京中医药大学中医学院,江苏 南京 210023||南京中医药大学附属南京中医院,江苏 南京 210022南京中医药大学中医学院,江苏 南京 210023||南京中医药大学附属南京中医院,江苏 南京 210022南京中医药大学中医学院,江苏 南京 210023||南京中医药大学附属南京中医院,江苏 南京 210022
医药卫生
外感热病热-痰-瘀-虚病机传变截断扭转祛邪护阴痰瘀同治搜络息风扶正透邪
《南京中医药大学学报》 2026 (5)
651-658,8
国家自然科学基金青年科学基金项目(82405261)国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]239号)国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函[2023]85 号)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[2022]75号)江苏省自然科学基金(BK20230449)江苏省名老中医药专家传承工作室建设项目(苏中医科教[2021]7号)江苏省中医温病研究工程研究中心(GJZL202402)云南省中医临床优秀人才研修项目(第一批)
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