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两宋医家辨治瘟疫学术思想探析OA

Study of the Academic Thoughts on the Diagnosis and Treatment of Epidemic Diseases by Doctors in the Two Song Dynasties

中文摘要英文摘要

[目的]研究两宋时期浙江医家治疫特色.[方法]采用概念梳理的方法,厘清寒疫、温疫等术语的演变与混淆;以文献分析法对两宋时期医家治疫思想进行探析;最后采用方药论证法,剖析宋代医籍中的方剂与用药原则,论证医家灵活施治的方法论.[结果]概念界定上,《伤寒例》虽已提出寒疫之说,但后人仍将寒疫、温疫、伤寒、温病混为一谈,直到两宋时期医家始将寒疫与温疫区别论治,首次明确寒疫及温疫概念.辨证论治上,医家提出因时制宜、随证施治原则,治疗温疫以清热解毒、芳香透邪为主,治疗寒疫则以辛温散寒为法,强调以平为期,不滥用温燥,整体上形成了治热以寒、治寒以热、治温以清的辨治体系.方药运用上,两宋医家注重药物间协同制约,治疗不一味采用伤寒方药,以清热解毒、芳香透邪之药治疗温疫,寒热相佐,因时制宜,随症施行,治热以寒、治寒以热、治温以清,以平为期.[结论]两宋医家在继承前人理论的基础上,以非时之气为核心病因学说,将疫病明确区分为寒疫与温疫,推动了中医疫病理论发展,也为后世温病学派的形成奠定了方法论基础.同时对寒温异治、以平为期的治则进行了深入实践,这一经验对于应对新发突发传染性疾病仍具有重要启示价值.

[Objective]To investigate the characteristics of epidemic management in Zhejiang in the two Song Dynasties.[Methods]By using the method of concept clarification,the evolution and confusion of terms such as cold epidemic and warm epidemic were clarified;the thoughts of physicians on treating epidemics during the two Song Dynasties were explored through literature analysis;finally,the method of prescription and drug argumentation was adopted to analyze the prescriptions and drug principles in medical books of the Song Dynasty,and to demonstrate the methodological approach of physicians in flexible treatment.[Results]In terms of concept definition,although Shanghan Li had already proposed the concept of cold epidemic,later generations still confused cold epidemic,warm epidemic,exogenous febrile disease and warm disease.It was not until the Song Dynasty that physicians began to distinguish and treat cold epidemic and warm epidemic separately,and clearly defined the concepts of cold epidemic and warm epidemic for the first time.In terms of syndrome differentiation and treatment,the physicians proposed the principle of adapting to the time and treating according to the syndrome.The treatment of warm epidemic mainly focused on clearing heat and detoxifying,and using aromatic drugs to penetrate the pathogen,while the treatment of cold epidemic emphasized using pungent and warm drugs to dispel cold.The principle of moderation was emphasized,and warm and dry drugs were not overused.Overall,a system of treating heat with cold,treating cold with heat and treating warm with clearing was formed.In terms of the application of prescriptions and drugs,the physicians of the Song Dynasty paid attention to the synergy and restraint among drugs.They did not blindly use prescriptions for exogenous febrile disease,but used drugs for clearing heat and detoxifying aromatic drugs to penetrate the pathogen to treat warm epidemic,with a combination of cold and heat.They adapted to the time and treated disease according to the syndrome,treating heat with cold,treating cold with heat,and treating warm with clearing,aiming for balance.[Conclusion]During the two Song Dynasties,medical practitioners built the theories of their predecessors and established a core etiological theory centered on abnormal atmospheric conditions.They clearly distinguished epidemic diseases between cold epidemics and warm epidemics,promoting the development of traditional Chinese medicine's epidemic theory,which laid the methodological foundation for the formation of the later.At the same time.the principle of treating differently for cold and heat and aiming for balance has been deeply practiced,and this experience still holds significant implications for dealing with new and sudden infectious diseases.

徐熙圣;张星

浙江中医药大学 杭州 310053浙江中医药大学 杭州 310053

医药卫生

两宋时期寒疫温疫病证结合脉证合参清热解毒辛温除湿寒热相佐

The Two Song Dynasty Periodcold epidemicwarm epidemicintegration of disease and symptomssynthesis of pulse and symptom informationheat-clearing and detoxifyingdispelling dampness with pungent and warm herbscooperation of cold and hot

《浙江中医药大学学报》 2026 (4)

415-419,5

浙江省哲学社会科学一般项目(22NDJC096YB)Zhejiang Philosophy and Social Sciences General Project(22NDJC096YB)

10.16466/j.issn1005-5509.2026.04.003

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