试论卫气营血辨证体系的本底疾病——以流行性脑脊髓膜炎为例

Discussion on the Underlying Disease of Wei(卫)-Qi-Ying(营)-Blood Syndrome Differentiation System:Taking Epidemic Cerebrospinal Meningitis as an Example

流行性脑脊髓膜炎(简称流脑)无论从发病季节、传染性、症状、病机以及传变特点等方面,均表现出与卫气营血传变规律的高度一致性,据此提出以流脑为例探讨卫气营血辨治体系的本底疾病。流脑从上呼吸道沿神经侵袭大脑,其总体发病规律遵循入肺(前驱期)→入血(菌血症期、败血症期)→入脑(休克期),结合疫病戾嗜定性原则,可分别对应卫气同病→气营两燔→热闭心包、热盛动风、内闭外脱。通过对《温热论》所述卫气营血传变规律及其本底疾病进行考证,旨在揭示卫气营血传变规律下的疾病模型原貌,用以指导临床实践。

Epidemic cerebrospinal meningitis shows a high degree of consistency with the law of transmission among wei(卫)-qi-ying(营)-blood,in terms of the onset of the season,contagiousness,symptoms,pathogenesis,as well as characteristics of the transmission.It is proposed to use epidemic cerebrospinal meningitis as an example to explore the underlying disease of wei-qi-ying-blood syndrome differentiation system.Epidemic meningitis invades the brain from the upper respiratory tract along the nervous system,and its overall pathogenesis follows from entering the lung system(prodromal period)to entering the blood(bacteremia period,sepsis period)and then entering the brain(shock period).According to the four-dimensional qualitative principle of epidemic pathogen tropism,it corresponds to disease of both wei and qi syndrome,then blazing of both qi and ying syndrome,and then heat blocking pericardium,exuberant heat stirring wind,and internal block and external collapse syndrome.This article explored the laws of transmission among wei-qi-ying-blood and its underlying diseases described in On Warm Heat(《温热论》),and revealed the original appearance of the disease model under the laws of transmission among wei-qi-ying-blood to guide the clinical practice.