中医杂志

总结韩明向教授从湿、热、郁、虚论治不明原因发热的临证经验。认为湿、热、郁、虚是不明原因发热的核心病机，临床可分为湿热郁结、郁火内伏、余邪恋肺、气虚发热、阴虚内热五种证型，分别运用龙胆泻肝汤合升降散加减以清热利湿、疏利气血，升降散合丹栀逍遥散加减以宣泄郁热、调畅气机，柴葛解肌汤加减以解表散邪、清透里热，补中益气汤加减以甘温益气、升阳泻火，玉女煎或知柏地黄丸加减以滋阴壮水、清退虚热。随证灵活用药，兼顾脏腑功能与气血阴阳平衡，可为不明原因发热的临证治疗提供思路。

This paper summarized the clinical experience of professor HAN Mingxiang in diagnosing and treating fever of unknown origin(FUO) from the perspective of dampness, heat, constraint and deficiency. He holds that the core pathogenesis of FUO lies in dampness, heat, constraint and deficiency. Clinically, FUO can be differentiated into five syndromes including binding constraint of damp-heat, constraint fire lodging internally, residual pathogen retained in the lung, fever due to qi deficiency, and internal heat due to yin deficiency. Accordingly, Longdan Xiegan Decoction and Shengjiang Powder （龙胆泻肝汤合升降散） with modifications can be used to clear heat and drain dampness, soothe qi and blood, and Shengjiang Powder and Danzhi Xiaoyao Powder （升降散合丹栀逍遥散） with modifications can be used for diffusing and discharging constraint heat, regulating and unblocking qi mechanism. Chaige Jieji Decoction （柴葛解肌汤） with modifications is suggested to release the exterior and dissipate pathogen, clear and vent interal heat, and modified Buzhong Yiqi Decoction （补中益气汤） to replenish qi with sweet-warm medicinals and to raise yang and drain fire. Yunv Decoction （玉女煎） or Zhibai Dihuang Pills （知柏地黄丸） with modifications should be used for enriching yin and supplementing fire, clearing and removing deficiency and heat. Formulas are flexibly adjusted according to syndrome differentiation, with emphasis on harmonizing zang-fu （脏腑） function and balancing qi, blood, yin and yang, thereby providing a therapeutic approach for the clinical management of FUO.