中医杂志

总结史载祥教授应用柴胡桂枝干姜汤治疗脓毒症高热的临证经验。认为脓毒症的关键病机为少阳郁热、水饮内结，其临床表现高热、寒战、往来寒热乃邪热郁结少阳所致，软组织水肿及浆膜腔积液则为少阳枢机不利、水饮内结所致。临证治疗脓毒症高热当兼顾软组织水肿及浆膜腔积液，以和解少阳郁热、化饮利水为法，应用柴胡桂枝干姜汤为基本方进行灵活加减，同时指出柴胡桂枝干姜汤对于多重抗感染无效的脓毒症高热有迅速退热的作用。

This paper summarizes Professor SHI Zaixiang's clinical experience in treating high fever caused by sepsis using Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤). He holds that the key pathogenesis of sepsis involves constrained heat in the shaoyang and internal accumulation of water and fluids. The clinical manifestations such as high fever, chills, and alternating sensations of cold and heat are attributed to pathogenic heat constrained in the shaoyang. Meanwhile, soft tissue edema and serous cavity effusions are due to shaoyang dysfunction and internal water retention. In clinical practice, treating sepsis-related high fever requires addressing both the shaoyang-constrained heat and the associated edema and effusions. The therapeutic approach focuses on harmonizing the shaoyang and resolving internal fluids, using Chaihu Guizhi Ganjiang Decoction as the base formula with flexible modifications. Professor SHI emphasizes that this formula shows a rapid antipyretic effect, particularly in cases where multiple antiinfective treatments have failed.