胎黄源流考

Origin and development of fetal jaundice

胎黄作为新生儿时期最常见的临床问题,大多数可自愈,然而其危重症危及生命,其防治一直是医学领域的研究重点。隋代巢元方《诸病源候论》首载胎疸,后世医家总结本病病变脏腑在肝胆、脾胃,病因病机有胎孕湿热,寒湿困脾,肝郁血瘀及胆汁外溢等。宋元明清历代医家对本病的认知不断完善,以利湿退黄为基本法则,提出多种辨治方法:清热利湿退黄法、温中化湿退黄法、化瘀消积退黄法等。祖国医学对本病辨治已有丰富经验,现将历代重要医籍中胎黄病的相关病症论述进行整理研究。

Fetal jaundice,as the most common clinical problem in the neonatal period,is mostly self-healing.However,its critical illness is life-threatening,so its prevention and treatment has been a research priority in the field of medicine.Fetal jaundice is first documented in General Treatise on Causes and Manifestations of All Diseases writed by Chao Yuanfang in Sui dynasty.Younger generation doctor summarizes that the pathological changes of the viscera are in the liver,gallbladder,spleen and stomach,and the etiology and pathogenesis include heat-dampness in pregnancy,cold-dampness encumbering spleen,liver depression and blood stasis,bile efflux,and so on.From Song dynasty to Qing dynasty,successive physicians’perceptions of this disease has been improved,and multiple methods of diagnosis has been proposed,based on the principle of removing dampness and eliminating jaundice,such as methods of clearing heat,removing dampness and eliminating jaundice,methods of warming the middle,removing dampness and eliminating jaundice,methods of resolving stasis,dispersing accumulation and eliminating jaundice,etc.Traditional Chinese medicine has rich experience in differentiation and treatment of this disease.Considering all together,this article collates and examines accounts of relevant discourses of fetal jaundice in successive generations crucial medical books.