探析伤寒“存津液”与温病“救阴”思想的联系与区别

Explore the Connection and Difference Between“Retaining Body Fluid”in Typhoid Fever and“Saving Yin”in Warm Febrile Disease

[目的]探讨伤寒“存津液”与温病“救阴”思想的联系与区别。[方法]比较《伤寒论》与温病代表著作中与“存津液”“救阴”治疗思想相关的治法、方药与病证。[结果]阴液的存失对伤寒与温病均有重要影响,两者联系之处在于,温病医家继承了《伤寒论》中的清热法、攻下法与滋阴法,化裁经方,立新治法,并拓展了临床运用范围。两者区别之处在于,在解表祛邪方面,伤寒以汗法为治疗手段,而温病以汗法为治疗目的;伤寒并有温阳、利水、通津等其他治法,温病以清热存阴、滋阴养血法治疗动风病证;伤寒治疗“护阳气”思想占主要地位,“存津液”则处次要地位,而温病治疗“救阴”思想占主要地位。[结论]在《伤寒论》中,阴液损伤可以是某一经病的病机,也可以是某病证的主症之一,或者可作为防患于未然思想,寓于解表祛邪之中;而温病阴伤作为病机,贯穿病程始终。伤寒部分存阴治法,被温病医家继承并发展,形成了温病坚阴育阴的治疗体系。

[Objective]To explore the connection and difference between“retaining body fluid”in typhoid fever and“saving Yin”in warm febrile disease.[Methods]To compare the treatment methods,prescriptions and symptoms related to the therapeutic ideas of“retaining body fluid”and“saving Yin”in Treatise on Febrile Diseases and representative works of warm febrile disease.[Results]The existence and loss of Yin fluid have important influence on both typhoid fever and warm febrile disease.The connection between the two lies in that the doctors of warm febrile diseases inherited the methods of clearing heat,purging and nourishing Yin in Treatise on Febrile Diseases,modified the prescriptions of cutting classics,established new treatment methods,and expanded the scope of clinical application.The difference between the two is that,in the aspect of resolving the symptoms and removing the evil spirits,sweating method is the means of treating typhoid fever,but the purpose of treating warm febrile disease.Typhoid fever also has other treatment methods such as warming Yang,promoting urination,and transporting Qi to unblock body fluid.The dynamic wind syndrome in warm febrile disease can be treated by clearing heat and nourishing Yin and blood.In the treatment of typhoid fever,the thought of“protecting Yang Qi”plays a major role,the thought of“retaining body fluid”plays a secondary role,and the thought of“saving Yin”plays a major role in the treatment of febrile disease.[Conclusion]In Treatise on Febrile Diseases,Yin fluid damage can be the pathogenesis of one of the six meridian diseases,also can be one of the primary symptoms of disease,or can be used as a nip in the bud thought lies in nourishing the evil spirits.However,as the pathogenesis of warm febrile disease,Yin injury runs through the course of the disease.Typhoid fever is partly treated with Yin,which has been inherited and developed by warm febrile disease doctors,forming a treatment system for warm febrile disease to strengthen Yin and nourish Yin.