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《伤寒论与危重症医学:从危重症医学和中西医结合角度探寻六经本原、剂量及实质内涵》

[Treatise on Febrile Diseases and critical care medicine: exploring connotation of original, dosage, and essence of six meridians from perspective of critical care medicine and integrative medicine].

作者信息

Xiong Xing-Jiang

机构信息

Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2018 Jun;43(12):2413-2430. doi: 10.19540/j.cnki.cjcmm.2018.0073.

Abstract

Treatise on Febrile Diseases is one of the greatest classics in traditional Chinese medicine. Currently, so many key scientific problems including unclear connotation of the original, dosage of Chinese herbal medicine, and the essence of the six meridians were identified. On the basis of years of clinical experience in critical care medicine, it was advocated that the connotation of Treatise on Febrile Diseases should be explored from the perspective of critical care medicine and integrative medicine. It was identified that, the traditional study from the perspective of pathogenesis and textual research couldn't meet the current clinical needs due to its repeated deduction and circular argument in conceptual terms and unclear diagnosis and prognosis of modern diseases. The concept of exogenous febrile disease is the narrow sense, the essence of which may be acute febrile infectious diseases. Treatise on Febrile Diseases is a monographs for critical care medicine. The clinical manifestation of so many critical care medicine can be identified in Treatise on Febrile Diseases. The distinction standard of Treatise on Febrile Diseases and Synopsis of Golden Chamber is not external injury but contagious disease. The dosage problem in Treatise on Febrile Diseases mainly refers to large dose. The essence of six meridians in Treatise on Febrile Diseases is severe infection. Six meridians are different stages of severe infection, including the inflammation-based three Yang stages and deficiency-based three Yin stages. Additionally, the six meridians could be recognized by look, while not speculation. The struggle between cold and warm schools could be unified based on our research. The most direct and fundamental methods in studying Treatise on Febrile Diseases lies in critical care medicine and integrative medicine. The modern research of Treatise on Febrile Diseases is intensely calling for new treatment principle based on pathogenesis combined with pathology and property combined with pharmacology. Therefore, cultivation of ability in critical care medicine and integrative medicine should be emphasized in future studies.

摘要

《伤寒论》是中医最伟大的经典著作之一。目前,已发现诸多关键科学问题,包括原著内涵不明、中药用量以及六经实质等。基于多年重症医学临床经验,主张从重症医学和中西医结合角度探索《伤寒论》内涵。经研究发现,从病机和考据角度进行的传统研究,因在概念上反复推导、循环论证,且对现代疾病诊断和预后不明,无法满足当前临床需求。外感热病概念为狭义,其实质可能是急性发热性传染病。《伤寒论》是一部重症医学专著。《伤寒论》中可发现诸多重症医学的临床表现。《伤寒论》与《金匮要略》的区分标准不是外感,而是传染病。《伤寒论》中的用量问题主要指大剂量。《伤寒论》六经实质是严重感染。六经是严重感染的不同阶段,包括以炎症为主的三阳阶段和以虚为主的三阴阶段。此外,六经可通过望诊识别,而非推测。基于我们的研究,寒温学派之争可得以统一。研究《伤寒论》最直接、最根本的方法在于重症医学和中西医结合。《伤寒论》的现代研究迫切需要基于病机结合病理、药性结合药理的新治疗原则。因此,未来研究应强调重症医学和中西医结合能力的培养。

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