1. 上海中医药大学附属曙光医院,上海,200021
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蒋健. 郁证发微(二十二)——郁证发热论[J]. 上海中医药杂志, 2017,51(5):7-12.
JIANG Jian. Fever Due to Depression Syndrome[J]. Shanghai Journal of Traditional Chinese Medicine, 2017,51(5):7-12.
探讨郁证性发热的病脉证治。大量古代医案显示,中医早已认识到七情内伤可引起发热,并总结出了相应的临床特征与治疗方法。惊恐、悲哀、忧思、悒郁以及郁怒等情志因素引起的郁证性发热多为低热、潮热、阵热,伴随症状纷繁多样。病机有虚实之分,实则有肝气郁结及化火、痰湿阻滞、瘀血内阻等,虚则与郁证性虚劳类同而表现为脏腑气血阴阳亏虚。治疗大法为泻实补虚,泻实包括疏肝泻火、祛痰化瘀,补虚主要为补益气血阴阳。现代医学功能性发热中的原发性低热、感染治愈后低热、夏季低热、生理性低热以及不明原因发热,凡其发病原因与精神因素相关者,均可大致归属于郁证性发热的范畴。
This paper mainly discussed the therapy and syndromes of fever due to depression syndrome.Through a large number of ancient medical records,it finds that traditional Chinese medicine had long realized that internal injury caused by excess of seven emotions can induce the fever,and summarized the corresponding clinical features and treatment methods.Fever due to depression syndrome can be caused by emotional factors,such as panic,sadness,over-thinking,depression,anger and so on,which manifest as mild fever,tidal fever,intermittent fever with various accompanied symptoms.The pathogenesis of this kind of fever has the difference between deficiency syndrome and excess syndrome.Pathogenic fire derived from stagnation of liver qi,phlegm-dampness stagnation and internal stagnation of blood are the parts of excess syndrome.Deficiency syndrome ascribes the causes to deficiency of qi and blood as well as yin and yang,which is similar to prostration due to depression syndrome.Reinforcing deficiency and reducing excess is the basic therapy of this kind of fever.Reducing excess includes soothing liver and clearing fire,dispelling phlegm and removing stasis.Reinforcing deficiency includes tonifying qi and blood as well as yin and yang.Parts of functional fever in modern medicine which associated with the emotional factors,such as primary low fever,low fever after cured infection,seasonal(summer) fever,and physiological fever as well as fever of unknown origin,can be approximately classified into the category of fever due to depression syndrome.
郁证发热病因病机从郁论治
depression syndromefeveretiology and pathogenesistreatment based on relieving depression
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