浅析《温热论》之湿热证治

<温热论>为温病学的奠基之作.叶天士不仅于温热创见非凡,对湿热证治亦有精辟立论.认为内外湿相合在湿热类温病的发病中起决定作用,分析其说,实将湿热类温病的外因及证候细分为温热挟湿证和湿热证两种,指出湿热证的主要病位在脾胃三焦,发展变化有伤阴伤阳两种机转,重视辨舌察并据此确立治法.治疗上,强调要分解湿热,而突出"以湿为本治"的原则,倡导祛湿当治从三焦,分消上下,尤其重视淡渗利小便以除湿;同时告戒治湿还须重佐理气,气畅湿易散,此外,要兼参体质,顾护阳气.

Analysis on Damp-Heat Syndrome and Its Treatment in The Treatise on Warm and Heat Pathogens

The Treatise on Warm and Heat Pathogens is a foundational work on the science of epidemic febrile diseases. Ye Tianshi not only has outstanding original idea for warm-heat syndrome and also has penetrating views for damp-heat syndrome and its treatment. He held that combination of internal and external dampness played a decisive role in attacking of warm-heat diseases. Based on analysis. exopathic cause and syndromes of epidemic febrile diseases of damp-heat types are divided into both warm-heat syndrome with dampness and damp-heat syndrome, and indicates that damp-heat syndrome mainly locates in the spleen, stomach and tri-Jiao. and it has two turns. i. e. injuring Yin and injuring Yang in development, pays attention to inspection of the tongue and rash. and based on which the therapeutic method is determined. In treatment, it is emphasized to remove damp-heat, protruding the principle "treating dampness as root", and advocating that dampness should be removed from regulating tri-Jiao, and dividing the uper-Jiao and the lower-Jioa, particularly pay attention to using diuresis for removing dampness; at the same time. for removing dampness, regulating Qi should be strengthened. When Qi freely flows, dampness is easily removed. In addition. Yang-Qi should be protected according to constitution of the patient.