试论“热入血室”的阶段性证治

Discussion on Phased Syndrome and Treatment of“Heat Invading Blood Chamber”

“热入血室”始见于《伤寒论》,后世医家对“热入血室”的论述集中于“血室”具体部位的探讨,而疏于其证治的研究。本文结合众家之言,认为血室非某一特指脏器,而泛指富藏血气之所,位于下腹,其生理特性与胞宫、肝、冲任等密切相关。在月经或类月经情况的特殊生理状态下,“热入血室”具有独特的动态病理过程,依据热与血的关系将其分为“外邪袭表”“热扰血室”“热陷血室”“热结血室”四个阶段。治疗上不拘泥于小柴胡汤和刺期门,结合机体状态提出针对性的分阶段治法,有助于开拓“热入血室”相关理论在泌尿生殖系统感染性炎症中的应用,提高相关疾病辨证论治的精准度。

“Heat invading Blood chamber”was first recorded in Treatises on Febrile Diseases.Later doctors’discussion on“Heat invading the Blood chamber”focused on the specific parts of the“Blood chamber”,and neglected the research on its syndrome,treatment and application.Based on the opinions of other scholars,this paper holds that the Blood chamber is not a specific organ,but generally refers to the place where Blood and Qi is stored.It is located in the lower abdomen,and its physiological characteristics are closely related to the uterus,Liver,Chong Meridian and Ren Meridian.In the special physiological state of menstruation or menses,‘Heat into Blood chamber’has a unique dynamic pathological process.According to the relationship between Heat and Blood,it can be divided into four stages:‘external pathogens attack surface’‘Heat disturbing Blood chamber’‘Heat trapping Blood chamber’and‘Hot Blood forming chamber’.The treatment is not limited to Minor Bupleurum Decoction and acupuncture Cyclic door point,and the targeted phased treatment method is proposed based on the body state,which is expected to help expand the application of the theory of‘Heat invading Blood chamber’in the infectious inflammation of the urinary and reproductive system,and improve the accuracy of syndrome differentiation and treatment of related diseases.