从《伤寒论》热厥论治脓毒症休克

Treatment of Septic Shock from Heat Syncope in Shanghan Lun

《伤寒论》中热厥的本质应为现代医学中脓毒症休克,二者皆由外界致病因素引起,均为急性感染性疾病引起的急危重症。"厥应下之"论述了热厥的治疗应以清热或攻下为主。脓毒症休克病因病机复杂,临证应四诊合参,辨证施治。若伴见阳明腑实证,治宜攻下,方以小承气汤内泄肠腑热结、外解厥阴气滞;若腑实未见,而是无形邪热内郁,阳气郁遏不能通达四肢,治以白虎汤甘寒清热,则里热得清、阳气得通,厥证可愈。

The essence of heat syncope in Shanghan Lun should be septic shock in modern medicine.Both of them are caused by external pathogenic factors,and they are acute and severe diseases caused by acute infectious diseases.That"syncope should be treated with purgation"discusses that the treatment of heat syncope should be mainly to clear heat or purgate.The etiology and pathogenesis of septic shock are complicated,and the clinical symptoms should be treated with synthesis of the four diagnostic methods and syndrome differentiation.If accompanied by syndrome of Yangming Fu excess,the treatment should be purgated.Xiaochengqi decoction can be used to achieve the effect of clearing the heat accumulation in intestines and fu viscera and external removing of qi stagnation in Jueyin.If the Fu viscera excess is not seen,invisible heat stagnates in the body,and yang qi depression can not reach the limbs,Baihu Decoction can be used to clear heat,then the internal heat is clear,Yang qi is unblocked,and syncope syndrome can be cured.