脱证源流考

Historical Change and Research Progress of TCM Theory and Clinical Treatment of Tuo Syndrome in TCM

脱证属临床常见危重证,轻则突然出汗、心悸、眼发黑晕、恶心,甚则瘫软昏仆不知人事。脱证多由气血暴虚或亡阴、亡阳所致,严重者元气衰微已极,阴阳有离决之势,为临床常见急证。脱证先兆以恶心、出汗及烦躁为信号,继而突然昏仆,不省人事,目合口开,鼻鼾息微,汗出如流,手撒便遗,四肢瘫软,手足发凉,脉微欲绝。是所谓“脱即死也,诸病之死,皆谓之脱”。中医理论体系详备,治疗方法多样,在脱证的预防及诊治上均具有一定优势。本文系研习中医经典文献后,以历史发展时间为序,自《黄帝内经》最早论述脱证到现今新冠病毒的防治,将历代中医不同论脱治脱体系的概况进行了系统归纳总结。

Tuo syndrome in TCM is a common clinical critical syndrome type,including sudden sweating,palpitations,black eyes,dizziness,nausea,and even the acute syndrome of paralysis,fainting and unconsciousness. It is commonly caused by qi and blood deficiency or yin depletion and yang depletion. In severe cases,the vigor of yin and yang is weakened,which is a common acute clinical syndrome. Symptoms of detoxification include nausea,sweating and irritability. Then the patient may suddenly fall unconscious,with eyes and mouth opening,nose snorting a little,sweat flowing,hands shedding feces,limbs becoming limp,hands and feet becoming cold,faint pulse verging on expiry. It is said that "Tuo means death,and the death of all diseases is Tuo." TCM has a comprehensive theoretical system and various treatment methods for Tuo syndrome and have certain advantages in its prevention and diagnosis. This article is based on the study of the classic literature of traditional Chinese medicine,in the order of historical development time,from the earliest discussion of Tuo syndrome in the Huangdi Neijing to the prevention and treatment of the coronavirus today,and systematically summarizes the general situation of different theories of syndrome differentiation in traditional Chinese medicine in the past dynasties,in order to provide some reference for clinical treatment.