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清代叶桂提出“久病入络”的络病发病规律。根据病毒性呼吸系统疾病的病程久暂为相对概念,通过系统梳理历代文献,发现“新感”属“新病”范畴,指出“新病”包括邪气初入正气未伤、旧病未除新病复起和痼疾猝发等类型,并不拘于外感疾病;“新感”指感受温热邪气、六淫和疫疠之气等所致的疾病,不同于现代中医药学名词术语中相对于“伏邪温病”而言的新感温病。基于《黄帝内经》“络-经-络”传变途径、《伤寒论》所述外邪由经络传至脏腑的发病规律,以及叶桂从“络”角度阐释的外感温热病传变规律,提出“新感入络”的概念,并进一步分析认为,“新感入络”符合病毒类呼吸系统疾病传变规律及病机特点,制定“清瘟解毒、宣肺泄热”治法,对病毒性呼吸系统传染病防控具有重要作用。
Abstract:In the Qing Dynasty, YE Gui proposed the pathogenesis of "chronic diseases entering the collaterals"as a rule for collateral diseases. In the context of viral respiratory diseases, the course of the disease is considered a relative concept. A systematic review of historical literature reveals that "new pathogens" belong to the category of "new diseases". It identifies that "new diseases" include types where the pathogenic qi initially invades without harming the righteous qi, where old diseases relapse while not being completely cured, and where chronic diseases suddenly flare up. These are not limited to exogenous diseases. "New pathogens" refer to diseases caused by the invasion of warm-heat pathogens, the six excesses, and epidemic qi, differing from the modern traditional Chinese medicine term "new warm diseases" related to latent heat diseases. Based on the "collaterals-meridians-collaterals" transformation pathway described in The Inner Canon of Yellow Emperor (《黄帝内经》) and the pathogenesis of external pathogens entering the zang-fu organs via the meridians as described in Treatise on Febrile Disease (《伤寒论》), as well as the external warm diseases' transformation rule explained by YE Gui from the perspective of collaterals, the concept of "new pathogen invading the collaterals" is proposed. Further analysis indicates that this concept aligns with the transmission and pathogenesis patterns of viral respiratory diseases. The treatment method of "clearing epidemic pathogens, detoxifying, and spreading the lung to relieve heat" is considered important for the prevention and control of viral respiratory infectious diseases.
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基本信息:
DOI:10.13288/j.11-2166/r.2025.08.003
中图分类号:R228
引用信息:
[1]贾振华.“新感入络”概念的提出及其临床应用价值[J].中医杂志,2025,66(08):775-779.DOI:10.13288/j.11-2166/r.2025.08.003.
基金信息:
国家自然科学基金(82130123); 国家中医药管理局中医药创新团队及人才支持计划(ZYYCXTD-D-202206); 河北省省级科技计划(24462501D)