从《温疫论》达原饮证转归及组方看“既病防变”思想

Disscussion on the Thoughts of “Early Treatment to Prevent Deterioration” form Dayuan Yin Syndrome’s Outcome and Composition in Wenyi Lun

2019年底新型冠状病毒肺炎爆发后,明代吴又可创制的达原饮被广泛运用,成为治疗湿邪郁肺型肺炎的推荐处方之一,在防疫抗疫工作中起到了重要的作用。笔者通过学习《温疫论》及相关文献,认为达原饮证病机为湿热之邪伏于膜原,服达原饮后有化为阳明燥热证之趋势,多用汗下法治疗。方中运用养阴清热药,可缓解湿热导致之渴证,佐制温燥药之偏性,更能在后续用汗下法之前固护阴津,阻止病邪传变恶化,其中蕴含"既病防变"思想,值得认真学习效法,以期提高临床疗效。

After COVID-19 outbroken, Dayuan Yin which created by WU Youke who lived in Ming Dynasty is widely used in the type of damp blocking up lung pneumonia. Dayuan Yin became one of the recommend prescription and play the significant role in antiepidemic works. According to Wenyi Lun and related documents, the author consider pathogenesis of Dayuan Yin syndrome is damp-heat factor hide in Muyuan. The tendency after taking medicine is transforming to Yangming heat syndrome. Treatment methods are diaphoresis and purgative therapy. Dayuan Yin contains heat-clearing drugs so that it can relieve thirstiness due to the damp-heat factor, restrict the heat of Xinwen drug and contribute to norish Yin or clear heat. It can effectively prevent the disease from worsening and imply the thought of "Early Treatment to Prevent Deterioration". It is worth learning and imitating to improve the clinical efficacy.