基于《素问·热论》三阳理论治疗外感发热的思路与案例分析

Approach and Case Analysis of Treating Exogenous Fever Based on the Three Yang Theory in “Su Wen∙Re Lun”

摘要: 外感发热是一种常见病、多发病。现代医学主要采用解热镇痛、抗感染等对症治疗，退热速度快，但存在症状反复、毒副作用、耐药等问题。《素问·热论》提出的“三阳经络受病”理论，为外感发热的辨证施治提供了重要指导。本研究基于该理论，探讨自拟柴桂退热方(柴胡、桂枝、葛根等)治疗外感发热的组方规律与临床价值。通过文献研究与理论分析，阐释“三阳同治”的治法内涵，解析该方以柴胡疏解少阳、桂枝解表散寒、葛根清泄阳明、黄芩与连翘清热透邪、炙甘草调和诸药的配伍机制。结合两则典型医案，阐明该方疗效显著，患者均在24~48小时内体温恢复正常，伴随症状明显改善，且未出现不良反应。结果表明，柴桂退热方紧扣三阳病机，临床运用安全有效，为中医药治疗外感发热提供了理论依据与实践参考。

Abstract: Exogenous fever is a common and frequently occurring disease. Modern medicine mainly adopts symptomatic treatments such as antipyretic and analgesic, anti infective, etc. The fever reduction rate is fast, but there are problems such as recurrent symptoms, toxic side effects, and drug resistance. The theory of “Three Yang Meridians Suffering from Diseases” proposed in “Su Wen·Re Lun” provides important guidance for the diagnosis and treatment of external fever. Based on this theory, this study explores the composition rules and clinical value of a self formulated Chaigui antipyretic formula (Chaihu, Guizhi, Gegen, etc.) for treating external fever. Through literature research and theoretical analysis, this paper elucidates the therapeutic connotation of the “Three Yang Tongzhi” formula, and analyzes the compatibility mechanism of the formula, which uses Chaihu to relieve Shaoyang, Guizhi to relieve exterior coldness, Gegen to clear Yangming, Huangqin and Forsythia suspensa to clear heat and eliminate evil, and roasted licorice to harmonize various medicines. Based on two typical medical cases, it is demonstrated that this formula has significant therapeutic effects. Patients’ body temperature returned to normal within 24~48 hours, accompanied by significant improvement in symptoms, and no adverse reactions occurred. The results indicate that Chaigui antipyretic formula closely follows the three yang disease mechanism, and is safe and effective in clinical application, providing theoretical basis and practical reference for the treatment of exogenous fever with traditional Chinese medicine.