中文摘要：
目的:通过研究古代典籍记载的外感热病文献资料,探求寒温统一的源流;运用三阴三阳系统辨证体系,从“时、位、性、度”四维角度归纳清代吴鞠通有关于温热病的症候、方药以及病位病性的医案诊籍文献;进一步运用基于《伤寒论》三系统划分所构建的中医人体解剖模型及十二单证理论统一寒温,为临床治疗外感热病提供新思路。方法:1.检索从先秦时期到明清时期有关于外感热病的相关文献,对收集的文献资料进行整理,总结出外感热病的源流,探求寒温统一的意义。2.对《临证指南医案》、《温热经纬·叶香岩外感温热篇》的案例进行分析研究,探寻温病学说和伤寒学说的联系。3.对《温病条辨》中有关于温热病的条文进行梳理,以三阴三阳“时、位、性、度”辨证体系为出发点对温热病所涉条文进行分类、归纳。4.将所归纳的温热病条文进行提炼总结,提出温热病发病的时间概念、温热病在人体表里枢三部的空间概念、温热病寒热虚实四性的属性概念以及温热病程度与愈后转归判断的概念。结果:1.外感热病包含伤寒和温病,其概念起源于《黄帝内经》与《难经》。鉴于《伤寒杂病论》中详论于寒而略于温的情况,温病经过历代医家的研究与发展,逐渐脱离《伤寒论》,在明清时期形成温病学派。通过基于《伤寒论》形成的三阴三阳辨证体系,规范后世繁杂的辨证方法,回归本源,以其自身的理法框架吸收温病学方药的方法进行寒温统一。2.通过对《温病条辨》中所涉及的温热病条文进行梳理,总结温热病的病时规律和发病程度,以此指导愈后判断和方药选择。3.在《温病条辨》所涉及温热病的条文中,根据其病症描述和方药分析,使用“表里枢”三系统和“寒热虚实”四性划分病位和病性,形成表热证、表实证构成的表阳病;表寒证、表虚证构成的表阴病;里热证、里实证构成的里阳病;里寒证、里虚证构成的里阴病;枢热证、枢实证构成的枢阳病;枢寒证、枢虚证构成的枢阴病这六病的核心证和纲领证的概念以及温热病合病并病的概念,并通过方证互测的方法总结出温热病中六病和十二单证的主方主药。4.在临床过程中运用三阴三阳辨证体系,能够通过外感热病六病的概念更加准确地诊断疾病,指导临床用药。结论:基于三阴三阳辨证体系梳理《温病条辨》中有关温热病的条文,将温热病以“表里枢”三部,结合“寒热虚实”阴阳属性的方式,形成全新的六病模式。通过对十二单证分类,再对温热病发生的时间、发病的部位、疾病的性质进行辨析,归纳出温热病发生及传变的病时、病位、病性规律,明确诊断,指导治疗;总结温热类温病的核心方剂,吸收温病学派方药精华,完善三阴三阳辨证体系详寒略温的不足;以此统一寒温,为基于人工智能的经方诊疗系统的研发提供理论支撑。
英文摘要：
Purpose:By studying the literature of Exogenous Febrile Diseases recorded in ancient books and records,this paper explores the origin of the unification of cold and temperature;by using the syndrome differentiation system of three yin and three Yang systems,from the four-dimensional perspective of "disease time,disease location,disease nature and disease situation",this paper sums up the medical records of WuJutong in Qing Dynasty about the symptoms,prescriptions and disease location of febrile diseases;and further uses the Chinese medicine based on the three system division of treatise on febrile diseases.The traditional Chinese medicine human anatomy model and twelve document theory,which provides a new way for clinical treatment of exogenous fever.Methods:1.Search the relevant literature about exogenous fever from the pre-Qin period to the Ming and Qing Dynasties,sort out the collected literature,summarize the origin of exogenous fever,and explore the significance of the unity of cold and temperature.2.This paper analyzes the cases of "clinical guide medical case","Wen re Jing Wei · Ye Xiangyan exogenous Wen re disease" to explore the relationship between the theory of febrile disease and the theory of typhoid fever.3.Based on the syndrome differentiation system of "disease time,disease location,disease nature and disease situation" of three yin and three yang,this paper classifies and summarizes the articles related to febrile diseases.4.This paper summarizes the articles of febrile diseases,puts forward the concept of time of febrile diseases,the concept of space of febrile diseases in the three parts of human body,the concept of attribute of febrile diseases cold,heat,virtual and solid,and the concept of the degree of febrile diseases and the judgment of their prognosis.Results:1.Exogenous febrile diseases include typhoid and febrile diseases.The concept of exogenous febrile diseases originated from Inner Canon of Huangdi and classicliterature.In view of the fact that the treatise on febrile diseases is more detailed than warm,the febrile diseases gradually separated from Treatise on Febrile Diseases and formed the school of febrile diseases in the Ming and Qing dynasties after the research and development of doctors of all ages.Based on the syndrome differentiation system of three yin and three Yang formed in Treatise on febrile diseases,this paper standardizes the complicated syndrome differentiation methods of later generations,returns to the origin,and unifies the cold and temperature with the method of absorbing the TCM prescriptions of febrile diseases in its own framework.2.By combing the articles of febrile diseases in the differentiation of febrile diseases,this paper sums up the regularity and degree of febrile diseases,so as to guide the judgment and selection of prescriptions and drugs after the recovery.3.According to the description of the disease and the analysis of the prescriptions and medicines,the article of "differentiation of the febrile diseases" divides the disease position and the disease nature by using the three systems of "exterior and interior pivot" and the four natures of "cold,heat,virtual and solid",forming the exterior Yang disease composed of exterior heat syndrome and exterior demonstration;exterior Yin disease composed of exterior cold syndrome and exterior deficiency syndrome;interior Yang disease composed of interior heat syndrome and interior demonstration;interior Yin disease composed of interior cold syndrome and interior deficiency syndrome;The concept of the core syndrome and the outline of the six diseases,and the concept of the combination of the two diseases,are summarized by the method of the mutual test of the six diseases and the twelve syndrome.4.Using the syndrome differentiation system of three Yin and three Yang in the clinical process can diagnose the disease more accurately and guide the clinical medication through the concept of six diseases of exogenous fever.Conclusion:Based on the syndrome differentiation system of three Yin and three Yang,this paper combs the articles about warm and hot diseases in the differentiation of warm diseases,and forms a new six disease mode by combining the three parts of "exterior and interior pivot" and the Yin-Yang attribute of "cold,heat,virtual and solid".By classifying the twelve syndrome,analyzing the time,location and nature of the onsetof febrile diseases,we conclude the pathogenesis,location and regularity of the onset and transmission of febrile diseases,make clear diagnosis and guide treatment,summarize the core prescriptions of warm febrile diseases,absorb the essence of the prescriptions of the warm diseases school,and perfect the deficiency of the three yin and three Yang syndrome differentiation system.Unification of cold disease and heat disease provide theoretical support for the research and development of the diagnosis and treatment system based on artificial intelligence.
