中医外感热病的源流探析与当代思考

Origin and evolution of exogenous febrile diseases in traditional Chinese medicine with contemporary reflection

外感热病是感受外邪所致、以发热为主症的一类疾病,发病原因多样,临床发热表现亦各异,从古至今都是中医研究的重点。早在先秦与《内经》《难经》时代,中医对外感热病就有诸多认识,随后东汉末年张仲景创立了六经辨治体系,魏晋隋唐时期重在整理与补充外感热病的内容,宋金元时期发展伤寒学说并增加了许多新的学术观点,明清时期发展与完善了疫病和温病学说,清代医家尤重视寒温融合,近现代医家则提倡中西医结合治疗。在各种新型的发热类流行病、传染病频发的当下,厘清中医外感热病的源流、发展历程及形成的不同学说,有助于现代临床应用和学术传承创新。

Exogenous febrile disease refers to a group of disorders chiefly characterized by fever due to contraction of exogenous pathogenic factors,with different disease causes and clinical manifestations.It has been a key research scope in traditional Chinese medicine(TCM)since ancient times.It was initially widely discussed in as early as the pre-Qin period and the era of Huangdi Neijing(Huangdi’s Internal Classic)and Nan Jing(The Yellow Emperor’s Classic of Eighty-one Difficult Issues).Then,at the end of the Eastern Han Dynasty,Zhang Zhongjing established the Six-channel Pattern Differentiation and Treatment System.During the Wei,Jin,Sui,and Tang Dynasties,emphasis was placed on sorting out and enriching the contents of exogenous febrile disease.During the Song,Jin,and Yuan Dynasties,the theory of cold damage was developed,and many new academic viewpoints emerged.The theories of epidemic disease and warm disease were developed and perfected in the Ming and Qing Dynasties.In the Qing Dynasty,doctors attached importance to the combination of cold damage and warm disease in the discussion of exogenous febrile disease.In the modern and contemporary times,doctors advocated the treatment of exogenous febrile diseases with integrated traditional Chinese and western medicine.Currently,at a time when various new types of infectious and febrile diseases frequently occur,it is helpful to clarify the origin,development course and various theories of exogenous febrile diseases in TCM for clinical application and academic innovation.