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从"中暍死"忌冷和热射病早降温辨析中暑证治

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酷暑炎夏易导致热射病的发生,严重者会导致死亡.在中医理论中,中暑为"暍".热射病作为中暑类疾病的一种,其急性期治疗倡导"早降温"多用冰浴等方法,而同属中暑,历代医籍对"夏日中热暍死"的治疗均谓"不可使得冷".临床若不能及时辨别二者的病机容易导致错误的施治,一旦混淆可能危及患者的生命健康.对此,本文探析"中暍死"与热射病急性期的病机,发现前者常见阴证,后者多呈阳证.由于证类不一,二者治则相异,又因禁忌不同,二者治法相殊,故而"中暍死"忌冷,热射病急性期需早降温,临床应注意辨析这两种中暑的证治,避免混淆.
Analysis of the Treatment of Heat Stroke and the Prohibition of Cold in"Zhong Ye Si"
The scorching heat can easily lead to the occurrence of heat stroke,and in severe cases,it can result in death.According to traditional Chinese medicine(TCM)theory,heatstroke is referred to as"Ye".Among heat-related illnesses,"heat stroke"advocates for early cooling,often employing methods such as ice baths during its acute phase,whereas historical TCM texts consistently warn against the use of cold treatments for"summer heat-induced death due to heat exhaustion".The failure to promptly differentiate between the pathogeneses of these con-ditions can lead to incorrect treatment,potentially endangering the patient's health when confused.This paper ex-plores the pathogeneses of"Zhong Ye Si"and acute thermoplegia,finding that the former typically presents as a yin pattern,while the latter predominantly exhibits a yang pattern.Due to their differing syndromes,their treatment principles differ,and because of their distinct contraindications,their therapeutic approaches vary.Therefore,"Zhong Ye Si"prohibits cold treatments,whereas early cooling is necessary for acute thermoplegia.Clinicians should carefully differentiate the treatment of these two forms of heatstroke to avoid confusion.

ThermoplegiaHeatstrokeSynopsis of the golden chamberZhong Ye SiSyndrome differentiation and treatment

谌子诺、孙燕

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湖北中医药大学,湖北武汉 430065

北京中医药大学仲景医学研究所,北京 100029

热射病 中暑 《金匮要略》 中暍死 辨证论治

国家自然科学基金北京中医药大学校级科研纵向发展基金

8207432590020172120017

2024

中国中医急症
中华中医药学会

中国中医急症

CSTPCD
影响因子:1.144
ISSN:1004-745X
年,卷(期):2024.33(8)