| 摘要: | 現代文獻認為瘰癧是慢性頸淋巴結核，與廣泛記載於中醫古籍中之瘰癧症狀似乎不甚一致，因此，本研究之目的在藉由分析與瘰癧相關之歷代典籍文獻，釐清瘰癧在各時期的意義，以正確認識瘰癧的病因病機。
研究中首先針對中醫古籍，探討歷代各瘰癧病證的部位、形狀、症狀與病因病機的異同與演變，共分析74本文獻，包括27本醫術書籍、19本方書、15本外科專書、6本中醫理論著作、5本兒科專著、2本女科專書。
研究結果顯示，瘰癧原指疾病具「虛損勞累受邪，結核累累相連，次第歷歷可見，久而歷貫上下」的特色，但不同時代對瘰癧的定義不同，瘰癧所涵蓋的病症也隨之不同，包括急慢性與惡性癧症。此外，雖然瘰癧名稱涵義原指慢性病，但至近代已被用來泛指各種淋巴結病變。
綜合研究結果，我們建議類似古典中醫病名之現代詮釋應更加謹慎，並追尋古籍中之發展脈絡以得到正確之認知，以免造成偏差與誤解。
Chinese medical term “Luoli”（瘰癧）has been considered as chronic scrofula according to the contemporary documentation. However, the Luoli’s syndromes stated in these recent records seem to be different comparing to many records in ancient Chinese medicine books. Therefore, the study aims to probe into the definitions and pathogenesis of Luoli by analyzing relevant references at different period of times.
In the beginning of the study, We explore the similarities, differences, and devolvement of the location, shape, symptoms, and pathogenesis of Luoli through seventy-four ancient Chinese medicial books in the history, including twenty-seven medical books, nineteen prescription books, fifteen surgical books, six Chinese medical theory books, five pediatrics books, and two obstetrics and gynecology books.
The outcome of the study shows that Luoli originally means a kind of disease which has a feature as follows: “It is characterized by deficiency, exhaust, and evil influence. It looks tuberculous, and those countless tubers are distinctly visible and connect together. After a period of time, it will spread from upside to downside.” However, the definition of Luoli varies in different periods, and the symptoms which Luoli covers also change from time to time, including acute, chronic, and malignant lymphadenopathy. In addition, though Luoli originally refers to a chronic disease, nowadays it has been explained as all kinds of lymphadenopathy.
According to the above analysis, we suggest that people shall be more cautious about interpreting a classical Chinese medicine term like Luoli. In addition, people should also understand the development of classical Chinese medicine terms through ancient Chinese medicine books in order to get true knowledge and to avoid deviation and misunderstanding. |
