摘要
[目的]以《温病条辨》中附子应用为切入点,探讨吴鞠通治疗温病时着重顾护阳气的学术思想。[方法]系统梳理2006年宋咏梅点校版《温病条辨》,筛选出所有包含附子的相关条文与方剂,结合方证互参、文献考证,归纳吴鞠通护阳思想及临床经验。[结果]文献统计提示,《温病条辨·三焦篇》共载含附子方27首(正文方22首、加减方5首),较《伤寒论》仅少7首。病因病机方面,吴鞠通提出寒湿伤阳、饮邪损阳、阴阳两虚、中阳不振、浊邪闭阻、阳气衰亡六大伤阳病机;辨治体系方面,构建“祛寒除湿护阳、温阳化饮通阳、刚柔并济阴阳、补火益土温中、祛浊通闭通阳、回阳救逆扶阳”六维护阳体系;确立“附子+”配伍模式,附子生用占比74%,常用剂量7.46~11.19 g,体现速效护阳特点。[结论]吴鞠通突破“温病忌附”的传统认知,创立寒温融通的护阳体系,其“附子+”配伍模式为毒性中药的临床应用提供了范式。深入研究吴鞠通的护阳思想,不仅深化了温病学护阳理论内涵,更为急危重症的中西医结合治疗开辟了新途径。
[Objective Objective]To explore WU Jutong’s academic thoughts of Yang preserving in febrile disease treatment,from the application of Aconiti Lateralis Radix Praeparata in Systematic Differentiation of Febrile Diseases(Wenbing Tiaobian).[Methods Methods]Systematically review the 2006 edition of Systematic Differentiation of Febrile Diseases collated by SONG Yongmei,screen all relevant passages and formulas involving aconite Lateralis Radix Praeparata,and summarize WU Jutong’s thought and clinical experience in Yang preserving,integrating pattern-formula correlation and textual research.[Results Results]Literature statistics indicated that 27 Aconiti Lateralis Radix Praeparata-containing formulas(22 core,5 modified)in the Tri-Jiao Chapter of Systematic Differentiation of Febrile Diseases,only 7 fewer than in Treatise on Cold Pathogenic Diseases(Shanghan Lun).In terms of etiology and pathogenesis,WU proposed six Yang-deficiency pathogensis,including cold-dampness impairing Yang,retained fluids damaging Yang,deficiency of both Yin and Yang,declining middle-Jiao Yang,obstruction by turbid pathogens,exhaustion and collapse of Yang Qi.In terms of diagnosis and treatment system,he built a six-dimensional Yang preserving framework:dispelling cold and dampness to protect Yang,warming Yang to resolve fluids to unblock Yang,balancing hardness-softness to regulate Yin-Yang,supplementing fire to warm middle-Jiao,eliminating turbidity to restore Yang flow and rescuing Yang collapse.WU proposed“Aconiti Lateralis Radix Praeparata+”compatibility mode,Raw Aconiti Lateralis Radix Praeparata was used in 74%of cases,common dosage was 7.46~11.19 g,with rapid Yang preserving efficacy.[Conclusion Conclusion]WU broke the“avoid Aconiti Lateralis Radix Praeparata in febrile diseases”contraindication,creating Yang preserving system which integrated cold and warm.His“Aconiti Lateralis Radix Praeparata+”model set a paradigm for toxic traditional Chinese medicine(TCM)use.In depth study of WU’s thoughts of Yang preserving deepens Yang preserving theory in Febrile diseases and paves new paths for TCM-western integration in critical care.
作者
周璇
胡正刚
周宏图
ZHOU Xuan;HU Zhenggang;ZHOU Hongtu(Zhejiang Chinese Medical University,Hangzhou(310053),China;Shaoxing City Keqiao District TCM Hospital,Medical Alli-ance General Hospital)
出处
《浙江中医药大学学报》
2026年第1期129-134,共6页
Journal of Zhejiang Chinese Medical University
关键词
附子
《温病条辨》
吴鞠通
护阳
临床经验
辨证配伍
《伤寒论》
Aconiti Lateralis Radix Praeparata
Systematized Differentiation of Febrile Diseases
WU Jutong
Yang preserving
clinical experience
syndrome differentiation and formula composition
Treatise on Cold Pathogenic Diseases
