基于“主客交”理论探析艾滋病发热病机及辨治思路

Pathogenesis and Treatment of AIDS Related Fever Based on Theory of “Host-Guest Interaction”

“主客交”理论出自吴有性《温疫论》,原用于指导温疫病的治疗,经后世医家补充发展,现多用于指导临床正虚邪恋之痼疾的治疗。艾滋病发热是人体感染人类免疫缺陷病毒(HIV)后,免疫功能被破坏,出现的各种机会性感染及肿瘤引起的一种常见临床症状。艾滋病发热的发生发展与“主客交”理论中正虚邪恋、外邪胶结于血脉、主客交浑的病机特点相似,故从“主客交”理论切入,探讨艾滋病发热的病机和辨治思路。认为肺卫不固,不能抵御外邪;脾气虚弱、气血津液耗伤、艾毒稽留、内生病理产物郁积,正气无力透邪为艾滋病发热的主要病机。在吴有性所创三甲散和“扶正祛邪,分离主客”治疗原则启示下,提出辨治艾滋病发热的思路,即透邪外出,引客离主;抓住本质,勿忘扶正;补托并用,分离主客。

The theory of“host-guest interaction”originated from WU Youxing’s Treatise on Warm Epidemic,which was originally used to guide the treatment of warm epidemic diseases.After the supplement and development of later doctors,it is now mostly used to guide the clinical treatment of chronic diseases of healthy qi deficiency and excessive pathogenic factors.AIDS related fever is a common clinical symptom caused by various opportunistic infections and tumors after the human body is infected with human immunodeficiency virus(HIV)and the immune function is destroyed.The occurrence and develop-ment of AIDS related fever are similar to the pathogenesis characteristics of healthy qi deficiency and excessive pathogenic factors,the adhesion of external pathogen in blood vessel and the interaction between host and guest in the theory of“host-guest interaction”.Therefore,the pathogenesis and treatment of AIDS related fever are discussed from the theory of“host-guest interaction”.It is believed that insecurity of lung-defense can not resist external pathogen.Spleen qi deficiency,depletion of qi,blood and body fluids,persistence of HIV,accumulation of endogenous pathological products,and inability of healthy qi to expel pathogenic factors are the main pathogenesis of AIDS related fever.Under the enlightenment of Sanjia Powder(三甲散)created by WU Youxing and the treatment principle of“reinforcing healthy qi and expelling pathogenic factors,separating host and guest”,the authors put forward the idea of differentiating and treating AIDS related fever,that is,expelling pathogen and leading guest from host,grasping essence and reinforcing healthy qi,simultaneous tonifying and expressing,and separating host and guest.