伤寒差后更发热及选方辨证探析

Analysis of Syndrome Differentiation and Prescription Selection of Fever after Recovery of Febrile Disease

各医家对伤寒差后更发热原因的认识主要有:余热未尽、劳复、邪在少阳、重感于邪。对脉浮和脉沉实选用方剂的观点主要有:脉浮用枳实栀子豉汤,脉沉实者加大黄;脉浮用麻桂剂,脉沉实用承气剂;脉浮用柴胡桂枝汤,脉沉实用大柴胡汤。本文认为,伤寒差后更发热应为劳复使然,无明显表里症状者,用小柴胡汤和解之;如脉浮,为病后正气尚虚,重感于寒,可用柴胡桂枝汤微发汗解之;如脉沉实,为饮食失节,里有宿食,可用大柴胡汤下之。

The main reasons for the fever after the recovery of febrile disease are as follows: the remaining Heat is not exhausted,overwork,the inner evil factor is in Shaoyang,and the outside evil factor is severely invading. The main points of view on the selection of prescriptions for Fu Pulse and Chen and Shi Pulse are as follows: Zhishi Zhizi Chi Decoction can be used for the former,and Dahuang (rheum officinale) should be added in the prescription for the latter;Ma Gui Prescription for the former,and Cheng QI Prescription should be used for the latter;Chaihu Guizhi Decoction can be used for the former,and Da Chahu Decoction can be used for the latter. This article believes that more fever after febrile disease is caused by overwork. In treatment of those without obvious symptoms,Xiao Chaihu Decoction should be used to reconcile that. In treatment of the disease with Fu Pulse,which is cause by Zheng Qi deficiency and being invaded by serious cold,Chaihu Guizhi Decoction can be used to sweat slightly. If there is Chen Shi Pulse,which is caused by indigestion,Da Chaihu Decoction can be used to solve the problem.