发病病机

Combination or overlapping of syndromes
Combination of syndromes refers to the simultaneous occurrence of syndrome in two or more meridians and areas. Overlapping of syndromes refers to that before a syndrome disappears another syndrome in other parts or meridians appears after the pathogens invading the body.
发病类型
Immediate onset
It means that a disease occurs immediately after the attack of pathogens and is also called sudden onset. 临床常见：①新感伤寒或温病 ②疫疠致病 ③情志遽变 ④毒 物中毒 Latent onset
基本病机 系统病机
中医病机学
疾病传变 症状机理
第二节
邪正盛衰
Preponderance and decline of pathogenic or healthy qi
从一定意义上来说，许多疾病的发生发展及 转归过程，就是邪正斗争及其盛衰变化的过程。 It refers to the changes of wax and wane in the struggle between the healthy and pathogenic qi in the occurrence, development of disease.
多见于疾病中期，或慢性病 迁延期。 Healthy qi and pathogenic qi being
locked in a stalemate
疾病好转，或痊愈。
邪去正虚
Withdrawal of pathogenic qi with decline of healthy qi
多见于重病的恢复期，将息 调养，方能康复。 病情加重，病势恶化，甚至 死亡。
邪盛正虚
Domination of pathogenic qi with decline of healthy qi
Recurrence of disease
邪未尽除
正虚 未复
诱发因素
复发
疾病少愈及复发
多见较重的外感 热病如湿温
休止与复发交替
如哮喘
急性发作与慢性缓解 期交替
如胆结石
食复 复感新邪 劳复
药复 气候、精神、 地域等
病后用药不当 疾病初愈，因形神过劳 或房室而致复发 疾病初愈，因饮食因素而致复发
复 发
邪气是发病的重要条件
1.邪气影响发病的性质、类型与特点 寒邪—寒证；阳邪（风、暑、火邪）—实热病证；外 感—卫表证候等等。 2.邪气影响病情与病位 疫疠—病重；伤于风者，上先受之； 正气不足是发病的内部因素
正气：是指人体的生理机能，包括对外界环境的适应能力、 抗邪能力和康复能力。
正气的作用方式：1.自身调节 2.抗邪防病，或感邪后驱 邪外出 3.病后或虚弱状态时的自我修复
3.正邪相搏，邪胜正负则发病 Struggle between healthy qi and pathogenic qi can decide whether there would be the onset 4.不同条件下，正与邪主导作用不同 In different conditions, which one playing a leading role depends
It refers to slow onset of disease after the invasion of pathogen. 临床常见：①外感湿邪 ②思虑过度；房室不节等
Secondary onset It refers to a condition that a new disease occurs on the basis of a primary disease. 临床常见：①间日疟反复发作—继发疟母 ②病毒性肝炎失 治误治—臌胀 ③糖尿病日久—目盲、坏疽等。
正气存内，邪不可干；邪之所凑，其气必虚；
正邪相搏，邪胜正负则发病 1.导致机能失常 2.造成形质损伤 3.改变个体体质特点
1.抵御外邪 2.驱邪外出 3.自和康复 4.影响证候类型
邪气损正
正气抗邪
不同条件下，正与邪主导作用不同
1. Climatic and regional factors 2. Living and social environment
1.感邪即发 immediate onset 2.伏而后发 latent onset 3.徐发chronic onset 4.继发 secondary onset 5.合病与并病 combination or overlapping of syndromes 6.复发 recurrence of disease
形成 表现
Pathogenesis of dificiency and excess
classification Characteristics of pathogenesis Causative factors Main symptom
excess
Six exogenous Being dominated pathogenic factors, High fever, rigors, high by exuberance of pestilential qi, and hoarse voice, full pathogenic qi phlegm retention, and forceful pulse dyspepsia, Weak constitution, Being dominated advanced stage of by insufficiency disease, after of healthy qi sudden onset of acute disease
真虚假实
至虚有盛候
含义 “虚”为病机本质，“实”为假象的病理状态。 形成 正气虚弱，脏腑气血不足，功能减退，气化无力所致。 表现 纳食减少，疲乏无力，舌淡嫩。又兼腹满（时减）、腹
痛（喜按）等假象。
真实假虚
大实有羸状 含义 “实”为病机本质，“虚”为假象的病理状态。
形成 热结肠胃、痰食壅滞、湿热内蕴、大积大聚，使实邪结
虚中夹实——如脾虚所致水肿 实中夹虚——如邪热炽盛灼津所致气阴两伤证
3.虚实转化conversion between deficiency and excess
由虚转实 由实转虚
4.虚实真假 true or false excess and deficiency （1）真虚假实 （2）真实假虚
第一节
病机学说概述
病机——即疾病发生、发展与变化的机理。 亦即病因作用于人体，致使机体某一部位 或层次的生理状态遭到破坏，产生或形态、 或功能、或代谢等方面的某种失调、障碍 或损害，且自身又不能一时自行康复的病 理变化。 Pathogenesis refers to the mechanism of the occurrence, development, and changes of disease.
deficiency
Listlessness and lassitude, shortness of breath and unwillingness to speak, lusterless complexion, thin and weak pulse
2. 虚实错杂deficiency-excess in coБайду номын сангаасplexity
复发的诱因
第九章 病机学说
Theory of Pathogenesis
关键性问题
Concept of pathogenesis Chracteristics of the pathogenesis theory Contents of the basic pathogenesis Transmission and development of disease
It means that pathogens incubate inside for a period of time and cause no disease after invading into the body when the body is stimulated by some factors, a disease occurs. 临床常见：①破伤风、狂犬病 ②伏暑、伏气温病 Chronic onset
发病的基本原理
1.邪气是发病的重要条件 Pathogenic qi is the important factor causing disease 2.正气不足是发病的内部因素 Deficient healthy qi is the intrinsic factor causing disease
中医病机学说的特点 整体观 辩证观
立足于整体联 系的病理观
以整体联系和运动 变化观点认识和研 究疾病
中医病机学说的结构与内容
邪正盛衰、阴阳失调、气血 失常、津液代谢失常 外感热病病机、脏腑、经 络、形体官窍病机 病位传变、寒热转化、虚 实转化 症状发生机理，包括全身 症状和各系统病变常见症 状机理
虚的病机
精气夺则虚 含义 特点
主要指正气不足，以正气虚为矛盾主要方面的病理 反应。 精、气、血、津液亏少和功能衰弱以及脏腑经络功 能减退，使机体抗病能力低下，正邪斗争不剧烈 的一系列虚弱、不足的证候。 先天禀赋不足、病后亏虚、多种慢性病耗损、邪气 损害等。 体质瘦弱，神疲乏力，声低气微，自汗，盗汗，疼 痛喜按，二便失禁，五心烦热，畏寒肢冷，脉虚 无力等。