探析《时病论》立法特色及雷氏宣透膜原法辨治启迪

On therapeutic characteristics of Shibing Lun and application of Lei’s moyuan-diffusing method

《时病论》是晚清著名温病学家雷丰博采众方复结合自身临证经验而作的一部时病专著,本文对书中以法代方、会通常变的学术思想及特色进行了研究总结,并深入探析了师于吴又可达原饮之法的雷氏宣透膜原法,从制法背景、证型症状及方药组成等3个方面将二者进行对比,发现该法与本次新型冠状病毒肺炎的辨治多有契合,亦佐证了随机活法乃《时病论》立法的核心。雷氏师古不泥,所拟诸法在理法方药等方面均自有其见解,结合了审因辨病、辨证论治及同病异治、异病同治、活法活用等原则,其会通常变的学术思想不仅对当今医者诊疗思路及临床思维的塑造有着深远影响,对新型冠状病毒肺炎(COVID-19)的诊治亦有一定的借鉴意义,且今已发表文章多证实膜原理论对新冠肺炎的辨治确有启迪,值得深入挖掘研究。

Shibing Lun(Treatise on Seasonal Diseases)is a monograph on seasonal diseases written by Lei Feng,a famous epidemiologist in the Qing Dynasty.The book recorded experiences of predecessors’formulas combining with Lei’s own clinical experiences.This paper summarized the academic ideas and characteristics of the monograph,which are stressing therapeutic methods rather than formulas and adapting therapeutic methods according to changing pathogenesis.Furthermore,this paper also analyzed Lei’s moyuan-diffusing method which is based on Wu Youke’s principle of Dayuan Yin(Moyuan-Diffusing Decoction),and made a comparison between the two methods from three aspects,including background of preparation,the symptoms of different patterns,and the composition of prescriptions.It is found that this method is in alignment with the treatment methods used for Corona Virus Disease 2019(COVID-19),which also proves that adjusting therapeutic methods according to pathogenesis is the key of the theory.Lei learned from the knowledge of the past without being bound by it,and used his own judgement in the treatment.His academic thought not only has far-reaching influences on shaping clinical thinking of doctors today,but can be used for reference in containing the prevalence of COVID-19.Moreover,many published articles have confirmed that moyuan theory is indeed enlightening in the treatment of COVID-19,which deserves further exploration.