试论下法在新型冠状病毒肺炎中的应用

Discussion on application of Xiafa in novel coronavirus pneumonia

下法的理论可追溯于《黄帝内经》,其方药详于《伤寒杂病论》,后深受金元时期医家思想的影响,至明清形成相对独立的体系。温病下法其理法方药均自成一派。结合目前新型冠状病毒肺炎病症特点,总结出病邪为疫毒之邪,兼夹湿浊。病机为手太阴肺经与足太阴脾经,两太阴同病,太阴阳明互为表里,两感而发。病位为半表半里之膜原处。秽浊邪气常停聚于肠腑,需给邪出路,因势利导,以下法逐之。根据疾病病程特点、患者体质因素,需用不同下法手段,且选取下法时机尤为关键。湿浊初起化热,予以开达膜原、以通为用;疾病传变,或热重于湿,或湿重于热;疾病后期,宣上逐下,中病即止。

The theory of Xiafa originated from the Inner Canon of the Yellow Emperor,and its prescriptions were discussed in detail in Treatment of Febrile and Miscellaneous Diseases.Later,due to the influence of the medical ideology of the Jin and Yuan Dynasties,it formed a relatively independent system in the Ming and Qing Dynasties.The theories and prescriptions of Xiafa were all in their own way in warm diseases.Based on the current characteristics of novel coronavirus pneumonia,we summarized that the disease is an infectious and poisonous pathogenic qi,mixed with dampness.The pathogenesis is concurrent disease of two Taiyin,including Lung Meridian of Hand-Taiyin and Spleen Meridian of Foot-Taiyin.In addition,Taiyin and Yangming are interlinked,they are also concurrent.And the disease position is in interpleuro-diaphragmaticspace.The turbidpathogenic qi often gathers in intestinal,so it’s necessary to let it out by Xiafa.According to the characteristics of the course of the disease and the physical factors of the patient,different methods are required,and selecting the timing is particularly critical.When the damp factor just began to heat up,we should open the interpleuro-diaphragmatic space by Xiafa.When the disease spreads,either heat is greater thandampness,or dampness is greater than heat.When in the late stage of the disease,we should open the inhibited lung-energy and lower pathogenic qi,and stop the medicine as soon as it is effective.