薛生白“余邪清透”学说对疫病瘥后调护的指导作用浅析

An Analysis of Xue Shengbai's Idea of“Clearing and Penetrating the Remaining Evil”on the Post-disease Care of Epidemic Diseases

薛生白所著《湿热病篇》是临床指导湿热病乃至湿热疫辨治的经典性著作,其清透湿热余邪的辨治思想较为系统。经分析发现,薛氏尤其注重湿热余邪留滞三焦、经络、肝胆等脏腑的影响,治疗方面常结合各脏腑的功能特点,注重气机的条畅与气阴的清补。当余邪留滞三焦时,采用宣畅三焦气机之法;针对余邪留滞经络之轻者采用养阴以祛邪,重者则采用活血通络、破滞散瘀之法;当邪留肝胆时则采用清热利胆、养心安神之法。针对湿热化燥伤阴、中气不足的状态,倡导调补中气,促使气机和畅;兼见肺胃阴虚者,则采用补肺养阴法治之。薛氏在用药方面注重用清轻宣化之品宣畅三焦湿热余邪,多选用药食两用之品清补气阴。同时,也倡导鲜药取汁送服香燥药物、特殊炮制等特色疗法的运用,对临床湿热疫瘥后调护具有较强的指导意义和实用价值。

Xue Shengbai's book Shi Re Bing Pian is a classic work for clinical guidance on the identification and treatment of damp-heat diseases and even damp-heat epidemics,and his idea of clearing the residual evil of damp-heat is more systematic in its identification and treatment.After analysis found that Xue's especially focus on the residual evil of damp-heat stagnation of the Sanjiao,Meridians,Liver and Gallbladder and other viscera,treatment often combined with the functional characteristics of the viscera,focusing on the smooth flow of qi and qi-yin clearing and tonic.When the residual evil stagnates in the Sanjiao,the method of clearing the qi of the Sanjiao is used;for the lighter cases of residual evil stagnating in the meridians,the method of nourishing yin is used to dispel the evil,and for the heavier cases,the method of invigorating blood to open the meridians,breaking up stagnation and dispersing stasis is used;when the evil stays in the liver and gallbladder,the method of clearing heat to benefit the gallbladder and nourishing the heart to calm the mind is used.For the state of damp-heat,dryness and yin injury,and deficiency of middle qi,he advocates tonifying middle qi to promote the smooth flow of qi;for the deficiency of lung and stomach yin,he adopts the method of tonifying lung and nourishing yin.In terms of medicine,Xue focused on the use of light and cathartic products to promote the release of damp-heat residual evil in the three jiao,and the use of medicinal and food products to clear the qi and yin.At the same time,he also advocates the use of fresh herbal juice to deliver fragrant and dry drugs,special concoctions and other characteristic therapies,which have strong guiding significance and practical value for clinical post-disease care of damp-heat epidemics.